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Medical Services Only (MSO)


Policy

Eligibility for Medical Services Only: April 30, 2010

MSO Clients Receiving the Tube Feed Supplement: April 30, 2010

Eligible Health Supplements for MSO: April 30, 2010

Ineligible Items: April 30, 2010

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Eligibility for Medical Services Only: April 30, 2010
April 30, 2010

Medical Services Only (MSO) is a client category intended to assist some recipients transitioning to self-sufficiency as they move from income assistance or disability assistance into employment or other income support programs.  MSO coverage provides specific health supplements to certain categories of former recipients of income or disability assistance.

The family unit (including the spouse if the spouse was a dependant at the time the family unit became MSO and remains a dependant) is eligible for MSO as long as the family unit continues to reside in BC and one adult in the family unit meets one of the eligibility criteria listed below:

Clients NOT in Receipt of the Tube Feed Supplement
MSO Reason Eligibility Criteria Timeframe
Persons with the PWD designation, PPMB, or persons receiving special care, who leave assistance at age 65 or older Must be in receipt of the federal Guaranteed Income Supplement or the federal Spouse’s Allowance

As long as eligibility criteria are met

If client no longer meets eligibility criteria, they remain eligible for MSO for one year from the date they became ineligible
Persons with the PWD designation who are under age 65, who leave assistance for pension or other payment under the Canada Pension Plan (CPP)

Must be in receipt of pension or other payment under the Canada Pension Plan (CPP)

When the person reaches age 65, they must be in receipt of the federal Guaranteed Income Supplement or the federal Spouse’s Allowance

As long as eligibility criteria are met

If client no longer meets eligibility criteria, they remain eligible for MSO for one year from the date they became ineligible

Persons with the PWD designation, who are under age 65 who leave disability assistance for employment

Persons with the PWD designation, PPMB, or persons receiving special care who are under age 65 who leave assistance for awards from Crime Victim Assistance

Must be eligible to receive Medical Services Plan (MSP) Premium Assistance

When the person reaches age 65, they must be in receipt of the federal Guaranteed Income Supplement or the federal Spouse’s Allowance

As long as eligibility criteria are met

If client no longer meets eligibility criteria they remain eligible for MSO for one year from the date they became ineligible
Persons with the PWD designation who leave assistance for the Ministry of Children and Family Development’s Agreements with Young Adults. Retains MSO for the duration of their agreement, as long as they are receiving Medical Services Plan (MSP) Premium Assistance For the term of their agreement
Persons with the PWD designation, PPMB, or persons receiving special care who leave assistance due to receiving a lump sum payment as part of the CPP mediated class action settlement agreement. Retains MSO indefinitely Indefinitely
Persons who were designated MSO under BC Benefits (prior to 2002) Retains MSO indefinitely Indefinitely

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MSO Clients Receiving the Tube Feed Supplement: April 30, 2010
April 30, 2010

MSO clients under the age of 65 that were in receipt of the tube feed supplement on the date the family unit ceased to be eligible for assistance will retain the tube feed supplement as long as they are in receipt of MSP Premium Assistance.  Eligibility for all other MSO supplements for clients under the age of 65 depends on the reason for leaving (CPP, employment, etc.).

Once that person reaches age 65, eligibility for all MSO supplements will require that a family unit be in receipt of the federal Guaranteed Income Supplement or the federal Spouse’s Allowance, with the exception of the tube feed supplement.  In order to retain the tube feed supplement only, the person must be eligible to receive MSP Premium Assistance.

MSO clients receiving the tube feed supplement that cease to be eligible for MSO retain access to eligible health supplements through MSO one year from the date they became ineligible.

Clients Receiving the Tube Feed Supplement
MSO Client Reason Eligibility Criteria – Supplements other than the Tube Feed Supplement MSO Eligibility Criteria – Tube Feed Supplement Only Timeframe
Persons with the PWD designation, PPMB, or persons receiving special care, who leave assistance at age 65 or older Must be in receipt of the federal Guaranteed Income Supplement or the federal Spouse’s Allowance Must be eligible to receive Medical Services Plan (MSP) Premium Assistance

As long as eligibility criteria are met

If client no longer meets eligibility criteria they remain eligible for MSO for one year from the date they became ineligible
Persons with the PWD designation who are under age 65 that were in receipt of the tube feed supplement at the time they became MSO who leave disability assistance for pension or other payment under the Canada Pension Plan (CPP)

Must be in receipt of pension or other payment under the Canada Pension Plan (CPP)

When the person reaches age 65, they must be in receipt of the federal Guaranteed Income Supplement or the federal Spouse’s Allowance

 Must be eligible to receive Medical Services Plan (MSP) Premium Assistance

As long as eligibility criteria are met

If client no longer meets eligibility criteria they remain eligible for MSO for one year from the date they became ineligible

Persons with the PWD designation who are under age 65 that were in receipt of the tube feed supplement at the time they became MSO who leave disability assistance for employment

Persons with the PWD designation, PPMB, or persons receiving special care under age 65 that were in receipt of the tube feed supplement at the time they became MSO who leave disability assistance for awards from
Crime Victim Assistance

Must be eligible to receive Medical Services Plan (MSP) Premium Assistance

When the person reaches age 65, they must be in receipt of the federal Guaranteed Income Supplement or the federal Spouse’s Allowance

 Must be eligible to receive Medical Services Plan (MSP) Premium Assistance

As long as eligibility criteria are met

If client no longer meets eligibility criteria they remain eligible for MSO for one year from the date they became ineligible
Persons with the PWD designation that were in receipt of the tube feed supplement at the time they became MSO who leave disability assistance for the Ministry of Children and Family Development’s Agreements with Young Adults. Retains MSO for the duration of their agreement Retains MSO for the duration of their agreement Retains MSO for the duration of their agreement
Persons with the PWD designation, PPMB, or persons receiving special care that were in receipt of the tube feed supplement at the time they became MSO who leave disability assistance due to receiving a lump sum payment as part of the CPP mediated class action settlement agreement Retains MSO indefinitely Maintains eligibility indefinitely Indefinitely

Example #1:

A PWD client in receipt of the tube feed supplement leaves assistance at age 58 due to an award from Crime Victim Assistance.

The client will retain the access to all supplements eligible under MSO including the tube feed supplement as long as they are eligible to receive MSP Premium Assistance until they reach age 65.

When that client reaches age 65, they must be in receipt of the Guaranteed Income Supplement or the federal Spouse’s Allowance to retain access to all health supplements other than tube feeding available under MSO. To retain eligibility for the tube feed supplement only, the client must be eligible to receive MSP Premium Assistance.

Example #2:

A PWD client in receipt of the tube feed supplement leaves assistance at age 58 for CPP-D.

The client will retain the tube feed supplement as long as they are in receipt of MSP Premium Assistance regardless of age.

Other than tube feeding, the client will retain access to all health supplements eligible under MSO as long as they are in receipt of CPP-D until age 65. When that client reaches age 65, they must be in receipt of the Guaranteed Income Supplement or the federal Spouse’s Allowance to retain the other health supplements.

The family unit (including the spouse if the spouse was a dependant at the time the family unit became MSO and remains a dependant) is eligible for MSO as long as the family unit continues to reside in BC and one adult in the family unit meets the eligibility criteria listed above.

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Eligible Health Supplements for MSO: April 30, 2010
April 30, 2010

Clients eligible for Medical Services Only (MSO) may have access to only the following health supplements provided that they meet the eligibility criteria of the specific supplement [see Related Links]:

  • medical supplies

  • medical equipment and devices

  • dental services

  • optical (basic eyewear and repairs)

  • eye examinations (if under age 65)

  • infant health supplement (infant formula)

  • extended medical therapies

  • medical transportation

  • Medical Services Plan (MSP) coverage [see Related Links – Medical Services Plan and Medical Coverage]

  • No deductible PharmaCare coverage [see Related Links – PharmaCare]

  • tube feed supplement (if the person is in receipt of the tube feed supplement at the time their family unit transitions to MSO)

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Ineligible Items: April 30, 2010
April 30, 2010

Persons with MSO files are not eligible for any of the following (this list is not all-inclusive):

  • diet supplements

  • monthly nutritional supplement

  • nutritional supplements (except infant formula)

  • orthodontics

  • tube feed supplement (if the person is not in receipt of the tube feed supplement at the time their family unit transitions to MSO)

  • natal supplements

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