A recent study conducted by UBC and SFU researchers highlighted the adverse impacts of the mandatory three-month waiting period for BC Medical Services Plan (MSP) coverage for all immigrants to BC.
The study, which focuses on the experiences of immigrant women in particular, found that the three-month waiting period ultimately results in negative health outcomes, health inequities and long-term health problems for racialized immigrant women and their families. The wait period produces unexpected costs, and subsequently unmet needs for care, which builds mistrust and internalized stigma regarding the healthcare system.
While the study is primarily concerned with family health, students can also be affected by the three-month waiting period for MSP, especially with rapidly changing circumstances surrounding COVID-19. Many students have had trouble accessing BC vaccine cards due to a lack of a BC Medical Services Card, for example.
iMED coverage is not always effective
New-to-UBC international students are charged a small fee and automatically enrolled in iMED, a temporary private health insurance plan, for their first three months in BC.
While two medical facilities at UBC Vancouver allow direct billing to iMED, most medical facilities require payment upfront, for which reimbursement can be claimed at a later date.
iMED is meant to cover emergency hospitalization and medical services, such as unexpected sickness and injuries. However, some had trouble accessing these services.
Camelia Amteyaz, a third-year undergraduate international student who recently transferred to UBC Vancouver campus from the Okanagan campus, expressed dissatisfaction with the health insurance system here in BC.
In her first year, Amteyaz suffered a concussion. At the hospital, she was told that the visit would cost a couple thousand dollars without MSP coverage. She was given Tylenol and encouraged to go to a walk-in clinic if she had severe symptoms.
“I think that this three months is crazy … iMED doesn’t cover everything, apparently, which I thought it did.”
A few months later, Amteyaz started experiencing headaches again, and went back to the clinic. The doctors said the root cause was the head injury she had experienced earlier.
“I definitely 100 per cent agree with the findings of that study,” she says. “[The concussion] had, like, very long term effects, because of me not having MSP.”
Improved access is a necessity
Dr. Shira Goldenberg, the director of research education at the Centre for Gender & Sexual Health Equity and one of the principal investigators of the study, said that the study is in no way raising a new issue, but bringing light to ongoing issues that have in some ways been further amplified by COVID-19.
The bigger issue at hand, Goldenberg said, is coupling healthcare with immigration status.
“If somebody is a resident in BC, they should be able to access care.”
One group of students heavily affected by the pandemic are those who have just graduated, she pointed out. While under the process of renewing their immigration documents, students are under “implied / maintained status,” which originally was not covered by MSP. However, as a response to COVID-19, the province has announced that those under implied status may be eligible to apply for temporary MSP coverage.
The study authors worked closely with Sanctuary Health, a grassroots community collective which actively advocates against the MSP three-month wait. Omar Chu, a member of Sanctuary Health, describes the collective’s goal as “advocating for access to services based on need, regardless of immigration status.” He highlighted the stress and complicated situations caused by the three-month wait, particularly for those under implied status.
Not everyone suffers from exceptional circumstances, but many are simply unhappy with the three-month waiting period being in place. Jasleen Grewal, a former PhD candidate at UBC, said that the uncertainty and lack of transparency associated with health insurance for international students is concerning.
It’s challenging to navigate the system as a new resident, and healthcare costs during the three-month wait, with or without insurance, are not clearly communicated.
“You’re sort of just like, tied to whatever somebody is willing to give you by way of that three month waiting period coverage. I think it ends up being a very exploitative environment,” Grewal said.
Grewal could not personally speak to experiences of mistrust or internalized stigma as found in the study. However, she highlighted a part of the study regarding knowledge on community support centres. While a number of community-funded support resources are available in BC, she believes knowledge of and access to such sources could be greatly improved.
“Making health insurance sort of be the last thing you have to worry about when you come to a new country would be a great change ultimately.”
AMS VP External Saad Shoaib said that the AMS will be working with UBC to improve access to information and student support resources. He said he also plans to advocate against the three-month waiting period for MSP. International student health needs being unmet due to cost is “completely unacceptable,” Shoaib said.
“We're going to be working with the university … [and] actively lobbying the province on making sure that MSP waiting period is being looked at being removed,” Shoaib said.
“We hope that the province is going to reconsider this three-month waiting period, because, within that time, the health of our international students is not being considered. And that is simply, unequivocally and absolutely unacceptable.”
Sanctuary Health’s petition calling to repeal the three-month wait is linked here.