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Are private clinics legal in BC? The Medicare Protection Act, the Cambie case and when you can pay privately

Private clinics are legal; charging MSP enrollees for MSP-insured services is not. The Cambie case ended in 2023 with the law intact. Covers legal private options and how to complain.

Updated 2026-10-29

Yes. BC law does not ban private clinics, and most family practices are privately run by doctors. What the Medicare Protection Act prohibits is charging MSP enrollees for medically necessary services that MSP insures, and selling private insurance for those services. [1][2][3]

What the Medicare Protection Act says

  • Doctors and clinics may not charge patients, or anyone on their behalf, for MSP-insured services. [1]
  • They may not charge related fees under other names, such as consumables, equipment "rental", tray fees or facility fees. [1]
  • They may not charge for priority access to waitlisted services. [2]
  • Opted-out doctors bill patients directly and patients claim back from MSP, but the charge cannot exceed the MSP rate. [1]
  • Doctors not enrolled in MSP who provide insured services in hospitals, care facilities or health authority settings may charge no more than the MSP rate. [1][2]
  • Selling private insurance for medically necessary MSP-insured services is prohibited (section 45). [3]

These provisions were passed in 2003 but only fully brought into force in October 2018. Fines for extra billing are up to $10,000 for a first offence and up to $20,000 for a later one. [4]

How the Cambie Surgeries case ended

Cambie Surgery Centre, its founder Dr. Brian Day and other plaintiffs argued that these limits, combined with long waits, violated the Canadian Charter of Rights and Freedoms. The case went through three levels of court and the law did not change. [5][6][7]

DateCourtResult
September 2020BC Supreme Court (2020 BCSC 1310, Justice Steeves)Claim dismissed. Waits engaged security of the person, but not contrary to the principles of fundamental justice. [5]
July 15, 2022BC Court of Appeal (2022 BCCA 245)All three justices dismissed the appeal, with differing reasons. [6][7][3]
April 6, 2023Supreme Court of CanadaLeave to appeal dismissed; the case ended. [7]

The challenged provisions, including sections 14, 17 and 18 on billing and section 45 on private insurance, remain in force. [3][7]

Private services that are legal

SituationNotes
Services MSP does not coverCosmetic surgery, driver's and immigration medicals, exams for work or school, massage, counselling and similar services can be paid privately. [8][1]
Paid by WorkSafeBC or ICBCTheir arrangements with private clinics are not affected, because these services are not MSP benefits. [2]
Non-residentsVisitors and people without MSP are billed; residents of other provinces are usually billed to their home plan, sometimes with patient charges. [9]
Publicly contracted surgeryHealth authorities pay private clinics and patients pay nothing. About 5% of surgeries (16,777) in 2021-22 were done this way. [10]

Membership and annual-fee clinics

Some clinics charge an annual fee to cover uninsured items like sick notes and forms. Under the CPSBC standard the fee must be optional: patients who decline can still get insured care, cannot be refused as new patients, must not be treated less favourably, can rescind within one week for a refund, and the fee covers at most one year. [11][1]

The Medical Services Commission has taken legal action against companies offering expensive paid programs. In a June 2024 settlement, one company agreed to tell patients they do not need to pay for its program to receive MSP benefits. [12] See our clinic fees guide for details.

If you think you were charged improperly

  1. Keep the receipt and note the item, date and doctor's name.
  2. Ask at the time what the charge is for and whether it is an MSP-insured service. [2]
  3. If you believe you paid for an insured service, submit the Beneficiary Submission for Extra Billing Investigation form to Health Insurance BC. Phone: Lower Mainland 604-683-7151, elsewhere in BC 1-800-663-7100. [1]
  4. You can also email the Medical Services Commission at [email protected]. [2]
  5. Concerns about a doctor's conduct can go to CPSBC.

Getting care in the US or China

  • Elective care outside Canada must be approved by MSP in advance, even if urgent; otherwise you pay all costs. [13]
  • For emergencies abroad MSP pays little: $75 CAD a day for in-patient hospital care, while US hospitals often charge over US$1,000 a day and up to US$10,000 in intensive care. [14]
  • MSP does not pay travel, accommodation, take-home drugs or non-physician services. [13]
  • The government advises buying travel medical insurance before leaving, even for a one-day trip. [13][14]
  • If you will be away six months or more in a calendar year, contact Health Insurance BC to confirm eligibility. [14]
  • Bring back test reports, discharge summaries and a medication list so your Canadian doctor can follow up.
Rules, amounts and phone numbers reflect official pages checked in October 2026 and may change; check the BC government and CPSBC for current information. This guide explains the rules and does not judge public or private care.

Sources