Healthy Kids
Last updated on June 21, 2023Overview
The Healthy Kids Program provides coverage for basic dental treatment, optical care and hearing assistance to children in
low-income families, who are not in receipt of income assistance, disability assistance or hardship assistance.
As of January 1, 2020, eligibility criteria for the Healthy Kids Program is based on eligibility for Medical Services Plan (MSP) Supplementary Benefits. This is due to the elimination of MSP premiums and premium assistance programs. There is no change to the financial eligibility criteria for Healthy Kids coverage as the income test for supplementary benefits is equivalent to the previous premium assistance income test.
Policy
Eligibility
Effective: January 1, 2020
The Healthy Kids Program provides coverage for basic dental treatment, optical care, and hearing assistance to children in low-income families, who are not in receipt of income assistance, disability assistance or hardship assistance. Children in families eligible for MSP supplementary benefits under Medical Services Plan (MSP) through the Ministry of Health are eligible for the Healthy Kids Program.
[For more information on MSP supplementary benefits, see Contacts.]
[For a brochure on the Healthy Kids Program, see Additional Resources.]
Dental and optical services are provided in accordance with the Ministry of Social Development and Poverty Reduction’s fee-for-service schedules. [For details of dental and optical coverage, see Related Links – Dental and Orthodontic Services and Optical Services.]
Hearing instruments include hearing aids, bone anchored hearing aids, cochlear implants, repairs, and related items. Coverage is provided for the least expensive, appropriate hearing instruments based on an assessment completed by either an audiologist or Hearing Instrument Practitioner and when the family has no other resources available to pay for the item. Preauthorization must be obtained by the hearing instrument provider. [For information on hearing instruments, see Related Links – Medical Equipment - Hearing Instruments.]
The ministry may provide a monthly alternative hearing assistance supplement to children in low income families to assist in meeting costs associated with overcoming barriers related to having permanent profound bilateral hearing loss if the child cannot significantly benefit from a hearing instrument for the purpose of speech comprehension. [For information on the alternative hearing assistance supplement and how to apply, see Related Links – Alternative Hearing Assistance Supplement.]
A family has the right to reconsideration of a denial of service under the Healthy Kids program through the Ministry of Social Development and Poverty Reduction’s Reconsideration and Appeal process. [For details of the Reconsideration and Appeal Process, see Related Links - Reconsideration and Appeal.]
Procedures
Confirmation of Coverage
Effective: September 1, 2017
Prior to treatment, parents should provide their child’s Personal Health Number and advise their dentist, optician, or hearing instrument provider to contact the ministry’s contracted insurance provider, Pacific Blue Cross, for confirmation that their child is covered under the Healthy Kids Program.
[For details of coverage, see Related Links – Optical Services and Dental and Orthodontic Services. For information on hearing instruments, see Related Links – Medical Equipment - Hearing Instruments. For more information on how to apply for the alternative hearing assistance supplement, see Related Links – Alternative Hearing Assistance Supplement.]
Reconsideration and Appeal
Effective: September 1, 2017
If the applicant has been denied dental treatment, optical care, or hearing instruments under the Healthy Kids Program, they may contact the Healthy Kids Program to request information [see Contacts].
If the applicant has been denied the alternative hearing assistance supplement under the Healthy Kids Program, they may contact the Contact Centre to request information [see Contacts].
[For details of the Reconsideration and Appeal Process, see Related Links – Reconsideration and Appeal.]
Authorities and Responsibilities
Responsibilities
Effective: September 1, 2017
The Healthy Kids Program Contractor,Pacific Blue Cross is responsible for:
- determining eligibility for dental, optical, and hearing supplements
Reconsideration Branch is responsible for:
- adjudicating requests for reconsideration
Contact Centre is responsible for:
- providing general information on the Healthy Kids program
Frequently Asked Questions
Question Are children who are listed as dependants on their parent’s BCEA file eligible for dental, optical, and hearing supplements through the Healthy Kids Program? Or is the Healthy Kids Program solely for low-income families who are not on assistance?
Answer The Healthy Kids Program is for children from low-income families when the family is not in receipt of assistance. Children in receipt of assistance are eligible for optical, dental, and hearing supplements through their income assistance, hardship assistance, or disability assistance case.
Question Are the same optical, basic dental, and hearing supplements provided to children on assistance and children from low-income families?
Answer Yes.
Question What happens when my child turns 19 or ages out of the Healthy Kids program?
Answer When a person in BC reaches the age of majority, 19 years, that person is no longer eligible for services under the Healthy Kids Program. The Healthy Kids coverage remains active until the end of the month of their 19th birthday.