Before You Go, Think MSO: What You Need to Know about PWD and Medical Services Only

By: 

Meg Tronson

Are you someone receiving persons with disabilities assistance (PWD) through the Ministry of Social Development and Social Innovation who will stop receiving cheques once you turn 65? Do you have PWD status but have stopped receiving ministry assistance due to employment income? If so, you may still be eligible for medical benefits even though you are no longer receiving ministry cheques. Welcome to MSO.

 

What is MSO?

MSO stands for Medical Services Only. With MSO you retain some of your enhanced medical benefits despite no longer receiving cheques from the ministry.

 

How do I qualify for MSO?

There are two criteria you must meet to be eligible for MSO. First, you must have a Persons with Disability (PWD) or Persons with Persistent Multiple Barriers (PPMB) designation and go off provincial assistance due to receiving income above your assistance amount from another source. Second, you must meet ministry standards for financial eligibility. In addition, you must request that the ministry change your file to MSO in the month that you no longer receive ministry cheques; otherwise the ministry will close your file within two months.  Don’t hesitate to call a TAPS advocate if you have questions or concerns about the ministry closing your file.

In order to qualify for MSO if you have PPMB designation, you must no longer be eligible for PPMB assistance due to income you (or your spouse) received from one of the following sources:

  • Old age security (OAS)/Guaranteed Income Supplement (GIS)
  • Crime Victim Assistance
  • Lump sum payment from CPP class action settlement

In order to qualify for MSO if you have PWD designation, you must no longer be eligible for PWD assistance due to income you (or your spouse) received from one of the following sources:

  • Employment income
  • OAS/GIS
  • Crime Victim Assistance
  • CPP or CPP-D payments
  • Family maintenance payments
  • Lump sum payment from CPP class action settlement
  • MCFD’s youth agreement

Generally, people on regular income assistance do not qualify for MSO. However, you may qualify if you have moved into a special care facility and have stopped receiving ministry cheques in the past month because of income from any of the following sources:

  • Old age security (OAS)/Guaranteed Income Supplement (GIS)
  • Crime Victim Assistance
  • Lump sum payment from CPP class action settlement

 

How do I know if I am financially eligible for MSO?

Depending on your age, the ministry uses different markers to determine financial eligibility. If you are 64 years of age or younger, financial eligibility is based on whether you qualify for Medical Services Plan (MSP) Premium Assistance. If you are single and have an income under $30,000 per year, or if you have a spouse and your combined income is under $40,000 per year, you should qualify for MSP Premium Assistance. You can also phone MSP’s toll free number at 1-800-663-7100 to ask if you meet MSP Premium Assistance financial eligibility criteria.

If you are 65 years of age or older, your financial eligibility is determined by whether you are receiving the Guaranteed Income Supplement (GIS). If you are single and have a yearly income (excluding Old Age Security) of less than $17,376, you will qualify for both GIS and MSO.

 

How do I apply for MSO?

The ministry will likely not switch your PWD/PPMB designation to MSO after you stop receiving cheques. You will have to inform the ministry that you wish to receive MSO, and you can do so in one of two ways. First, if you receive PWD assistance, but go over your annual earnings exemption for employment income and are no longer receiving PWD assistance, you can make sure your file remains open and is transitioned to MSO by continuing to submit your monthly stubs to the ministry. When you report your monthly income, the ministry should switch your file to MSO and your file should remain open. However, we strongly advise that you also contact the ministry directly and request that your file be switched to MSO.

For all other cases (those involving non-employment income), you can phone the ministry and ask that they change your file to MSO. You must contact the ministry within two months of no longer receiving cheques, or they will automatically close your file.

 

What are some benefits available to me on MSO?

With MSO you can apply for additional medical benefits, but the ministry does not automatically provide these benefits. Each benefit has its own eligibility criteria, and application and appeal processes. It may be helpful to contact a TAPS advocate when applying for ministry benefits through MSO.

The following are some benefits you may access :

  • medical supplies
  • medical equipment and devices
  • dental services
  • optical (basic eyewear and repairs)
  • eye examinations (if not already covered by MSP)
  • infant formula supplement
  • extended medical therapies
  • medical transportation
  • premium free Medical Services Plan (MSP) coverage  
  • no deductible PharmaCare coverage
  • tube feed supplement (if the person is in receipt of the tube feed supplement at the time their family unit transitions to MSO)

 

Are there any benefits I can no longer access with MSO?

Yes. The ministry no longer provides the following supplements when they change your file to MSO:

  • diet supplements
  • monthly nutritional supplement
  • nutritional supplements (except infant formula)
  • 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

 

One last question: If a person had MSO designation before 2002, do they still qualify under the current legislation?

Yes. A person who had an MSO designation before legislative changes in 2002 is “grandfathered” in and is automatically eligible for all MSO benefits.