Newcomers to Canada: How Canadian Health Benefits Work

Moving can be overwhelming, especially if you are trying to figure out how things work in a new country. This article provides an overview on how health benefits work in Canada.

Canada’s Universal Healthcare System Provides Coverage for Physician and Hospital Services

Canada has a universal healthcare system or public health insurance, which means that you don’t have to pay for most healthcare services, including medically necessary physician and hospital services.

Each province and territory has their own health insurance plan and in British Columbia, ours is called the Medical Services Plan (MSP). MSP is administered by Health Insurance BC and is mandatory for all BC residents, including those who hold study and/or work permits or working permits on working holiday programs that are valid for a period of six months or more.

Newcomers to Canada must serve a waiting period for MSP. Generally, the waiting period consists of the balance of the month you arrive in British Columbia plus two full months.  It’s recommended that you arrange for private medical coverage during the MSP waiting period, either in your home country or Canada. Please refer to the UBC HR website for more information.

Consider the following scenario:

A new faculty member from the United States arrived in British Columbia on August 22, 2017. When will their MSP start?

Their MSP will start on November 1, 2017 (waiting period is the balance of August plus the months of September and October). 

Enrol for MSP once you arrive in British Columbia. Enrolment is not automatic, and delaying your enrolment may impact your coverage. If you have dependents (spouse and/or dependent children), you may also include them on your enrolment form.

To enrol for MSP through UBC, please complete the UBC Benefits Sign-On Session to complete your payroll, benefits and pension (if eligible) forms. Refer to your letter of offer for the paragraph that explains how to do this.

Depending on your appointment at UBC, you may be responsible for some, all or none of the monthly MSP premium cost.

Closer to the start date of your MSP coverage, Health Insurance BC will mail you a BC Services Card with your Personal Health Number. Each family member will receive their own card and number. When you use public healthcare services, present your BC Services Card to the medical clinic or hospital as proof of coverage.

Other Useful Information:

Coverage for Prescription Drugs

UBC faculty and staff and their dependents (spouse and/or dependent children) are eligible for prescription drug coverage through our Extended Health plan that is administered by Sun Life.

Depending on your appointment at UBC, you may receive 70–100% coverage for prescription drugs that are prescribed by a physician or dentist and obtained from a pharmacist.

Newcomers to Canada must wait for their MSP to start before their Extended Health coverage becomes effective. The only exception is if you enrol for private medical coverage with Sun Life (Sun Life Inpatriate Plan) during the MSP waiting period; if you enrol for this Plan, then your Extended Health coverage will start on the first of the month on or after your date of hire.

Enrol for Extended Health when you enrol for MSP. Enrolment is not automatic and delaying your enrolment may impact your coverage.

Once enrolled, Sun Life will mail a drug card to your home address. You will receive one card in your name if you have single coverage, and two cards in your name if you have couple or family coverage. When you are filling a prescription at the pharmacy, show your BC Services Card and your Sun Life drug card. The pharmacy will electronically submit your claim to Sun Life and you will pay the pharmacy for what the Plan does not cover.

Consider the following scenario:

A new faculty member went to a pharmacy to fill their prescription. The cost was $50. How much do they need to pay?

The new faculty member is enrolled under the UBC Faculty Extended Health Plan and prescription drug coverage is 80%. They should present their BC Services Card and Sun Life drug card to the pharmacy. The pharmacy will submit the claim to Sun Life and charge the new faculty member $10 for the prescription (Sun Life will cover $40 (80% of $50) and the faculty member pays the pharmacy what the plan does not cover $10 ($50 – $40)).

This example assumes that the faculty member has satisfied the Plan’s annual $25 annual deductible. If they have not, the faculty member would pay $30 for the prescription (Sun Life will cover $20 ($50 less $25 deductible multiplied by 80%) and the faculty member pays the pharmacy what the plan does not cover $30 ($50 less $20)).

For more information on how to make claims, including how to coordinate benefits (if you are covered under more than one Extended Health plan), please refer to the Making a Claim section of our website.

Enrol for Fair PharmaCare:

In British Columbia, BC PharmaCare, through their program Fair PharmaCare, provides financial assistance for the cost of eligible prescription drugs once your Fair PharmaCare deductible has been satisfied.

If you are enrolled for MSP, enrol for Fair PharmaCare. They will calculate your Fair PharmaCare deductible (based on family income) and provide you with a registration number. You will need to let Sun Life know your registration number so that they can coordinate payment of your prescription drug claims with PharmaCare once your Fair PharmaCare deductible has been satisfied.

Coordination happens behind the scenes, so there is no further action required by you other than enrolling for Fair PharmaCare and letting Sun Life know your registration number.

Coverage for Other Medical Services and Supplies

Our Extended Health plan that is administered by Sun Life also provides coverage for other medical services and supplies (up to specified maximums):

  • Services from registered psychologists/clinical counsellors, massage therapists, physiotherapists, chiropractors, acupuncturists and other paramedical practitioners
  • Vision care, including the cost of prescription contact lenses or eyeglasses
  • Medically necessary equipment ordered by a doctor, such as a wheelchair, hearing aids, custom-made orthopaedic shoes and orthotic inserts
  • Emergency medical care while travelling out of province
  • Medically necessary services, such as a private or semi-private hospital room, private duty nursing and ambulance services

You will be required to pay first and submit a claim to Sun Life for reimbursement. The only exception is if your service provider submits claims electronically on your behalf and accepts payment from Sun Life (you can ask your provider what their billing practice is). When making claims, you will need the plan numbers below. These numbers also apply for your dependents.

UBC Extended Health Plan Details:

            Benefits Provider: Sun Life
            Group/Policy: 025205
            Member/Certificate No: Your 7-digit UBC ID

For more information about your coverage, how to make claims and/or how to coordinate benefits (if you are covered under more than one Extended Health plan), please refer to the Extended Health and Making a Claim sections of the UBC HR website.

Coverage for Dental Services

Our Dental plan that is administered by Sun Life provides coverage for a wide range of dental services, from regular check-ups to major procedures such as root canals and crowns, as well as orthodontic work, up to specified maximums. These procedures may be provided by a licensed dentist, denturist, dental hygienist or anaesthetist.

Most dental offices will submit claims electronically on your behalf. You may be required to pay your dental office (which means Sun Life reimburses you for what the Plan covers) or your dental office will receive payment from Sun Life (which means that you only pay the office what the Plan does not cover). You can ask your dental office what their billing practice is. Inform your dental office of your plan numbers below.  These numbers also apply to your dependents.

UBC Dental Plan Details:

            Benefits Provider: Sun Life
            Group/Policy: 025205
            Member/Certificate No: Your 7-digit UBC ID

For more information about your coverage, how to make claims and/or how to coordinate benefits (if you are covered under more than one Dental plan), please refer to the Dental and Making a Claim sections of the UBC HR website.

Other Useful Information:

Want More Information? 

UBC HR invites you to attend a Benefits workshop, hosted at the Vancouver campus with video conferencing available at the Diamond Health Care Centre. Registration is required.

Benefits Workshop (in-person)
Wednesday, October 18, 2017
12:00 p.m. – 1:00 p.m.
Life Sciences Centre, 2350 Health Sciences Mall, Room 1002 (map)
Note: Register
Benefits Workshop (video conference)
Wednesday, October 18, 2017
12:00 p.m. – 1:00 p.m.
Diamond Health Care Centre, 2775 Laurel Street, Room 2230
Note: Register