TERRANOVA AND LABRADOR
Non-Canadians arriving in Newfoundland and Labrador must present the following documents: • Immigration document valid for at least one year. (Example: work permit; study permit; visitor permit). • Valid passport.
• Letter from university or employer (posted on arrival in Newfoundland and Labrador) certifying enrollment in a full-time program or employment for at least one year. OR • Permanent residence permit. (A copy of the front and back of the card is required.) Other documents may be requested by MCP at the time of registration in order to verify your identity or your eligibility. Good quality originals or photocopies are acceptable. The original documents will be returned to you after your request has been processed. MCP will not be responsible for any original documents that may be lost in the mail. NON-ELIGIBLE CANDIDATES The following people are not eligible for MCP coverage: • Tourists, passers-by and visitors. • Members of the Canadian Armed Forces or NATO forces. • Federal prisoners. • People who have an asylum certificate or asylum seekers. • People who move temporarily to Newfoundland and Labrador for a period of less than one year.
WAITING TIME If you are moving permanently to Newfoundland and Labrador from another province or territory, your health services will be covered under your previous plan as of the last day of the month you arrive in Newfoundland and Labrador. Labrador, plus two more months. In order to allow sufficient time for a change in coverage of your pre-MCP plan, you must apply for MCP coverage upon arrival in Newfoundland and Labrador. HEALTH CARE CARD If eligible for coverage, each person listed on the application will receive an ID number and MCP card. Keep the card with you at all times and present it whenever you need medical services. Contact the MCP if the card is lost, stolen, damaged or destroyed. The replacement card form is also available at doctor’s offices and hospitals across the province.
It is important that you inform MCP of any change of name, address or residence status.
Residence in Newfoundland and Labrador The Newfoundland and Labrador Medicare Act defines a resident as a person: “who resides and is ordinarily present in the province …”. Beneficiaries who establish their residence in another Canadian province must apply for health insurance in the province in which they reside. Eligible applicants can be classified into four groups: Canadian citizens, permanent residents, international workers, and international post-secondary students. The Medical Assistance Plan (MCP) requires documents that must be provided by the applicant to demonstrate eligibility for the plans. Canadian citizens must present documents confirming their citizenship status. This may include. • A social security card or document containing the applicant’s social security number (SIN) • A Canadian passport • A Canadian birth certificate • An official federal government ID that contains the applicant’s social insurance number and name. • Applications for newborn coverage require a birth certificate and a valid Health Care Plan (CPM) parent number.
Applying for coverage for an adopted child requires a copy of official adoption documents or a Notice of Placement Approval from the Department of Health and Community Services, as well as the child’s birth certificate. Applications for coverage for children adopted outside of Canada also require permanent resident documents for the child. Landed immigrants will be required to present the Canadian Register of Immigration Landing Documents. If newcomer status to Newfoundland and Labrador has been granted, proof of your intention to stay in Newfoundland and Labrador may be required. Canadian citizens and eligible permanent residents may also be required to provide the following, if applicable:
• A health insurance number or card from a previous province or territory • Proof that Canadian citizenship or the granting of this condition has not been lost upon return to Canada after a long stay abroad. • Proof of release from the Canadian Armed Forces or the Royal Canadian Mounted Police • Proof of release from federal prison. International workers coming to Newfoundland and Labrador will need to present a work permit (Work Visa). The work permit must be:
• issued before arriving in Canada • for an employer in Newfoundland and for a specific job in the province • valid for at least 12 months (with the exception of international healthcare personnel). International post-secondary students coming to Newfoundland and Labrador must present a study authorization (study permit). The study permit must be: • issued before coming to Canada • for a post-secondary educational institution in Newfoundland • valid for at least 12 months. All international applicants must have their valid foreign passport ready to be presented for identification.
Excluded categories The following categories are not eligible for plan coverage, even if they live in Newfoundland and Labrador: • Dependents of residents of another province or territory • Asylum seekers • International workers with work permits that do not meet the established criteria • International students with study authorization who do not meet the established criteria • Tourists and visitors • Dependents of one of the previously excluded categories • Personnel of the Armed Forces or the Royal Canadian Mounted Police • Federal prisoners • Personnel of the Armed Forces of other countries who are stationed in the province. Insurance claim submission requirements
If you have been treated by a physician in Canada who does not participate in the interprovincial settlement, or have obtained services excluded from the settlement, you will need to submit an out-of-province claim form. This can be submitted on your behalf by the doctor, in which case you will be asked to sign the form. If the doctor decides not to file a claim on your behalf or if you are obtaining medical services outside of Canada, you must submit the invoice on letterhead with a detailed list of fees and services. This information is necessary so that we can corroborate and assess your complaint. Then, an out-of-province claim form must be submitted, along with the letterhead invoice.
Beneficiary audit Beneficiaries, although they have the right to receive services from health providers, cannot make unnecessary use of medical services. When MCP suspects that a beneficiary is making unnecessary use of the services, a benefit use audit may be performed to determine the nature and cost of any abuse. Each suspected case of abuse is decided on its own merits, taking into account the individual circumstances and the medical history of the recipient. A beneficiary with a chronic illness requiring multiple treatment services is usually unaudited. The Newfoundland and Labrador Medicare Act allows the MCP to assess a recipient for abuse of services and also allows them to recover the cost of those services through legal action. The MCP may also require a beneficiary to enter into a contract to restrict services to a single physician. If the MCP determines that a physician is encouraging a recipient to abuse the health care plan, a physician practice audit may be performed.
The information provided on this site has been compiled as a guide to the programs and services of the Medical Assistance Plan and does not represent the complete rules of the program. For more information, contact MCP. This information is subject to change without notice. International students International students in full-time post-secondary programs in Newfoundland and Labrador may be eligible for MCP coverage.
The program applies to any foreign person who has obtained an official study permit from Citizenship and Immigration Canada before entering the country. The person must be attending a recognized higher education institution in Newfoundland and Labrador for a period of at least 12 months. The student’s dependents will also be covered by the MCP, as long as they live in the province and have the relevant documents to support their claim. To qualify for coverage, international students must apply for and receive an MCP (Medical Care Plan) card. Coverage will begin for eligible students and dependents from the date of enrollment in a full-time post-secondary program or upon arrival in the province. Eligible students must present a letter of enrollment from the educational institution at the time of enrollment, coverage must be renewed annually by providing an updated enrollment letter, your coverage ends at the end of the program. ‘studies or on the date of final departure from the province, whichever occurs first. Students must be attending school and residing in the province in order to use the coverage. Coverage is available for the services listed in the Health Care Services Regulations for the Insured and in the Hospital Insurance Plan Regulations. Health insurance for other services (eg, prescription drug coverage) may be available to international students through their post-secondary institution (eg, Memorial University).
International students temporarily leaving the province for vacation or other purposes may be eligible for out-of-province coverage for up to 182 days in a 365-day period. The residency requirement for international student beneficiaries must be met within each subsequent 365 day period in order to receive future out-of-province coverage. In order to secure provincial coverage, international students must apply for and receive an out-of-province coverage certificate.