How Does Health Insurance Work in Newfoundland and Labrador?

As a resident of Newfoundland and Labrador, you are eligible for public health benefits that will cover medically necessary services.

While the cost of medical care is rising everywhere, it remains accessible in Canada thanks in part to the public healthcare system. Healthcare in Canada is organized at a provincial level, and one’s home province provides it. While we still highly recommend having a private insurance policy to make sure you are covered for all medical conditions whether big or small, the Newfoundland and Labrador health plan will cover care including surgeries, hospital stays and diagnostic testing.

This page explains what Newfoundland and Labrador Medical Care Plan covers, eligibility, how to apply, the Manitoba health card and options for purchasing supplemental private health insurance.

What is NL MCP?

In Newfoundland and Labrador, publicly funded healthcare is available for all legal residents through the Medical Care Plan Newfoundland. It is most frequently referred to as MCP Newfoundland or NL MCP.

The Newfoundland and Labrador Medical Care Plan (MCP) is designed to cover the cost of physician’s services for residents of Newfoundland and Labrador. The plan is administered and overseen by the Department of Health and Community Services. Hospital services are available through the Hospital Insurance Plan.

Although the NL MCP health plan covers a variety of services, there are unfortunately many services they do not cover. A private health insurance plan can bridge that gap and give you comprehensive health coverage.

What is covered under NL MCP?

The NL MCP directly pays physicians’ services that are medically required for you. If you are an NL resident, you are eligible for insured medical services. Benefits include the following basic services:

• Medically necessary physician and hospital visits including accommodations and meals (some home visits may also be covered)
• Surgical, diagnostic and therapeutic procedures (including anesthetic supplies and services)
• Medically necessary pre-care and post-care
• Complete maternity care
• Diagnostic services (x-rays, labs)
• Some medically necessary dental-surgical procedures when performed in a hospital by a dentist or oral surgeon

What is not covered under NL MCP?

Notable services not covered by NL MCP include the following:

• Prescription drugs and vaccines
• Medical examinations required by a third party.
• Telemedicine
• Eye examinations (for corrective lenses), glasses and contact lenses
• Paramedical services such as acupuncture, chiropractor, optometrist, osteopath, naturopath, podiatrist and physiotherapist services.
• Elective procedures such as cosmetic surgery
• Reversal of a sterilization procedure
• Sex changes unless recommended by the Clarke Institute of Psychiatry
• Routine dental services (cleanings, scalings, fillings, etc.)
• Hypnotherapy

What is the Hospital Insurance Plan under NL MCP?

The MCP also covers both inpatient and outpatient hospital services when recommended by a doctor. Some examples of services covered can be found in our chart below.

Note that under the Hospital Insurance Plan, there are some notable services which not covered. these include:

• Charges incurred for preferred accommodation (private and semi-private rooms which are not medically required)
• Private duty nurses retained by the patient
• Drugs and appliances issued for use outside the hospital (with the exception of drugs listed under the Insured Out-Patient Services section)
• Services provided without specific medical indication (x-rays required for employment or insurance purposes, cosmetic surgery, etc.)
• Services provided in private non-approved Canadian diagnostic imaging facilities (MRI, CT, x-ray)
• Services related to therapeutic abortions performed outside Canada or in non-accredited Canadian facilities
• Ambulance service and other patient transportation, except when an in-patient of one hospital is conveyed to another hospital for special tests or treatment but remains an in-patient of the first hospital
• IVF

While NL MCP covers some basic medical services, it is likely that at some point you will require treatment outside of the scope of what they cover. A private health plan will protect you from having to pay large bills out of pocket for those services. To see what options are available to you, compare NL health insurance options now.

Am I covered by NL MCP when I am out of province?

If you are temporarily out of Newfoundland and Labrador, MCP will cover some of the costs of insured services. Keep in mind, that the full costs of medical services received in another province, territory or country may not be covered, especially outside of Canada. Travel insurance can pay for these services in other provinces and beyond.

If you plan to leave NL for a duration of 30 days or longer, whether for vacation, business or to study, you will need to obtain an Out-of-Province Coverage Certificate to make sure that your MCP coverage will not expire while you are away.

Am I eligible for NL MCP?

You are eligible for NL MCP if you are a resident of Newfoundland and Labrador. The Newfoundland and Labrador Medical Care and Hospital Insurance Act defines a resident as a person “who is lawfully entitled to be or to remain in Canada, makes his or her home in the province, and is ordinarily present in the province but does not include a tourist, transient or visitor to the province”.

How do I apply for NL MCP?

In order to apply for MCP, you will first need to complete the NL MCP application form below:

Once you have completed the form, you can either submit it by mail, fax or drop it off physically at an MCP office using their 24-hour mail drop-off slot. Be sure to include copies of appropriate identification and citizenship/immigration documents.

Examples of documents you can submit to prove your identity and citizenship or immigration status are:

• Canadian passport
• Canadian birth certificate

Canadian Citizens and Permanent Residents may also have to provide the following:

• previous province or territory’s health care number or card
• proof that Canadian citizenship/permanent residency status has not been forfeited if returning to Canada after a lengthy stay abroad
• proof of discharge from the Canadian Armed Forces
• proof of release from federal prison

The mailing addresses to send your application form are:

How do I get my NL MCP card?

You will need an MCP health card in order to access the medical services covered under the plan. Once your application is received, it will take approximately two weeks to process. After your application is processed, you will be issued an MCP card with your personal healthcare number and will be able to access covered services.

What is the NLPDP?

The Newfoundland and Labrador Prescription Drug Program (NLPDP) provides financial assistance to assist eligible residents with the cost of their prescription medications. There are five main plans under the program:

• The Foundation Plan provides 100% coverage of eligible prescription drugs for those who need the greatest support.
• The 65Plus Plan provides drug coverage to residents 65 years of age and older who receive Old Age Security Benefits (OAS) and the Guaranteed Income Supplement (GIS). You will be responsible for payment of the dispensing fee up to a maximum of $6.
• The Access Plan allows individuals and families with low incomes access to eligible prescription medications.
• The Assurance Plan provides prescription drug coverage to individuals/families where eligible drug costs exceed a certain dollar limit.
• The Select Needs Plan provides 100% coverage for disease-specific medications and supplies for residents with Cystic Fibrosis and Growth Hormone Deficiency.

How do I contact NL MCP?

If you need to contact Newfoundland and Labrador Medical Care Plan (MCP) you can do so by phone or email. Staff are available to answer questions by calling the St. John’s office at 1-866-449-4459 or the Grand Falls-Windsor office at 1-800-563-1557. Questions may also be sent by email to [email protected].

Did you like this article?