Health Insurance and Child Support in British Columbia: Complete 2026 Guide to Medical Expenses, MSP Coverage & Section 7 Costs

By Antonio G. Jimenez, Esq.British Columbia18 min read

At a Glance

Residency requirement:
To file for divorce in British Columbia, at least one spouse must have been habitually resident in the province for at least one year immediately before filing the divorce application, as required by section 3(1) of the Divorce Act. Both spouses do not need to live in BC — only one must meet this requirement. There is no separate county or district residency requirement.
Filing fee:
$290–$330
Waiting period:
Child support in British Columbia is calculated using the Federal Child Support Guidelines, which are based primarily on the paying parent's annual income and the number of children. The guidelines include standardized tables that set base monthly amounts by province. Additional 'special or extraordinary expenses' — such as childcare, medical expenses, or extracurricular activities — may be shared proportionally between both parents based on their respective incomes.

As of June 2026. Reviewed every 3 months. Verify with your local clerk's office.

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Under British Columbia law, health insurance costs for children are classified as Section 7 special expenses under the Federal Child Support Guidelines, requiring both parents to share medical and dental insurance premiums proportionally to their incomes. The portion of insurance premiums attributable to each child, plus any health-related expenses exceeding $100 annually beyond insurance coverage, must be divided between parents in addition to base child support table amounts. For a family where one parent earns $80,000 (60% of combined income) and the other earns $53,000 (40%), the higher-earning parent would pay 60% of all qualifying medical expenses while the lower-earning parent covers the remaining 40%.

Key Facts: Health Insurance and Child Support in British Columbia

CategoryDetails
Filing Fee$200 Notice of Family Claim; $210 with divorce (as of January 2026)
Residency RequirementOne spouse must reside in BC for 12 months before filing
Separation PeriodOne year living separate and apart
Insurance ClassificationSection 7 special expense under Federal Child Support Guidelines
Expense SharingProportional to parental incomes
MSP CoverageContinues automatically for children; must be on one parent's account only
Table UpdateOctober 1, 2025 (current through 2026)
Legal FrameworkDivorce Act, R.S.C. 1985, c. 3 and BC Family Law Act

How Health Insurance Costs Are Classified Under BC Child Support Law

Health insurance premiums for children constitute Section 7 special expenses under Federal Child Support Guidelines, s. 7(1)(b), which specifically identifies "that portion of the medical and dental insurance premiums attributable to the child" as a qualifying expense that parents must share beyond base table amounts. This classification applies to both employer-provided extended health benefits and private insurance policies purchased to cover children's medical needs. The Federal Child Support Guidelines, SOR/97-175, govern these expenses for all British Columbia families, whether divorcing under the federal Divorce Act or separating under the provincial Family Law Act.

The distinction between base child support and Section 7 expenses is critical for British Columbia parents. Base table amounts, calculated using the paying parent's gross annual income and number of children, cover ordinary daily expenses including basic healthcare needs. Section 7 expenses address extraordinary costs that fall outside normal day-to-day care, including insurance premiums, uncovered medical treatments, dental work, orthodontics, counselling, and prescription medications. Under s. 7(1)(c) of the Guidelines, health-related expenses that exceed insurance reimbursement by at least $100 annually automatically qualify as Section 7 expenses.

Calculating Proportional Shares of Medical Insurance Costs

British Columbia courts divide Section 7 expenses between parents based on their proportional share of combined gross annual income, ensuring that health insurance child support British Columbia obligations reflect each parent's ability to pay. For example, if Parent A earns $120,000 and Parent B earns $80,000, their combined income totals $200,000. Parent A's share equals 60% ($120,000 ÷ $200,000), while Parent B contributes 40% ($80,000 ÷ $200,000). If the children's portion of health insurance premiums costs $3,600 annually, Parent A pays $2,160 (60%) and Parent B pays $1,440 (40%).

The calculation process requires several steps that British Columbia parents must follow precisely:

  1. Determine each parent's gross annual income from all sources including employment, self-employment, investments, and rental income
  2. Calculate the combined total of both incomes
  3. Divide each parent's individual income by the combined total to establish percentage shares
  4. Apply those percentages to the net cost of the Section 7 expense after deducting any employer contributions, tax credits, or subsidies
  5. Document all calculations for court filing or separation agreement purposes

Under BC Family Law Act, s. 150, courts must order child support amounts consistent with the Federal Child Support Guidelines unless a departure is justified under specific circumstances outlined in the legislation.

Types of Health-Related Section 7 Expenses in British Columbia

The Federal Child Support Guidelines enumerate specific health expenses that qualify for proportional sharing between parents, covering both preventive care and treatment costs that exceed ordinary household medical expenses. Section 7(1)(b) and (c) of the Guidelines establish two distinct categories: insurance premiums attributable to children and health-related expenses exceeding $100 annually beyond insurance coverage.

Medical and Dental Insurance Premiums

The child-attributable portion of medical and dental insurance premiums qualifies as a Section 7 expense regardless of the premium amount. When a parent carries family coverage through their employer, the premium difference between individual and family coverage represents the children's share. If individual coverage costs $150 monthly and family coverage costs $350 monthly, the $200 monthly difference ($2,400 annually) constitutes the children's insurance expense subject to proportional sharing. This calculation applies to extended health benefits covering prescriptions, vision care, paramedical services, and dental care beyond basic MSP coverage.

Expenses Exceeding Insurance Coverage

Health expenses that exceed insurance reimbursement by at least $100 annually qualify under s. 7(1)(c), encompassing a comprehensive range of treatments and services:

  • Orthodontic treatment including braces, retainers, and related dental work
  • Professional counselling from psychologists, psychiatrists, social workers, and registered clinical counsellors
  • Physiotherapy and occupational therapy sessions
  • Speech therapy and language pathology services
  • Prescription medications not fully covered by insurance
  • Hearing aids and audiological services
  • Glasses, contact lenses, and vision therapy
  • Dental procedures exceeding insurance maximums
  • Mental health treatments including residential programs

MSP Coverage for Children After Separation in British Columbia

British Columbia's Medical Services Plan provides basic health coverage to all residents at no premium cost, and children's MSP coverage continues automatically following parental separation or divorce. However, children can only be registered on one parent's MSP account at a time, requiring parents to coordinate which parent maintains the child's enrollment. Under BC Health Insurance Act regulations, MSP coverage includes medically necessary physician services, hospital care, and diagnostic procedures for all enrolled residents regardless of family status changes.

When parents separate, they must update their MSP accounts to reflect the new family structure. The parent removing children from their account does not need supporting documentation, but the children must have coverage established under the other parent's account. For parents removing a spouse, the Ministry of Health requires either a notarized statement, affidavit signed by at least one spouse, or a dated statement signed by one or both spouses confirming the separation. Account changes take effect on the first day of the month following the request submission.

Fair PharmaCare Considerations

Children's prescription drug coverage through Fair PharmaCare follows different rules than MSP enrollment, requiring careful coordination between separated parents. Children can only appear on one parent's PharmaCare account, and they must be enrolled under the same parent who maintains their MSP coverage. Following separation, either parent may qualify for increased PharmaCare assistance based on changed income circumstances. The 2026 coverage year is calculated using 2024 income, but parents whose income dropped by 10% or more can request an income review for adjusted deductibles and family maximums.

Parents should contact PharmaCare at 1-800-663-7100 immediately after separation to report changed circumstances and potentially access significantly increased prescription drug assistance. A dependent child qualifies for PharmaCare coverage if they are 18 or younger, or aged 19-24 and attending school or university full-time.

Extended Health Benefits and the Birthday Rule

When both parents maintain extended health benefit plans through their employers, British Columbia follows the coordination of benefits birthday rule to determine which plan pays first for children's claims. Claims go first to the plan of the parent whose birthday falls earlier in the calendar year, regardless of which parent has primary parenting time. If the father's birthday is March 15 and the mother's birthday is September 22, the father's plan pays primary for all children's extended health claims, with the mother's plan covering any remaining eligible expenses as secondary.

Parenting orders and separation agreements should specify which parent maintains workplace coverage for children, particularly when only one parent has access to employer-sponsored benefits. Courts regularly include provisions requiring the parent with coverage to maintain children on their plan and provide coverage cards and claim information to the other parent. The cost of premiums, including any employee contributions for dependent coverage, constitutes a Section 7 expense subject to proportional sharing regardless of which parent carries the coverage.

How Courts Assess Section 7 Medical Expense Claims

British Columbia courts evaluate Section 7 expense claims using a two-part test established in the Federal Child Support Guidelines: the expense must be necessary in relation to the child's best interests, and it must be reasonable in relation to the parents' means and the family's pre-separation spending patterns. Under s. 7(1) of the Guidelines, courts consider "the necessity of the expense in relation to the child's best interests and the reasonableness of the expense in relation to the means of the spouses" before ordering proportional sharing.

The necessity requirement examines whether the expense genuinely benefits the child's health, development, or wellbeing. Medically recommended treatments, professionally prescribed therapies, and preventive care measures typically satisfy this threshold. The reasonableness assessment compares the expense to the family's historical spending and the parents' current financial circumstances. A family that previously spent $5,000 annually on orthodontics and extracurricular activities cannot claim that similar post-separation expenses are extraordinary simply because they now require coordination between two households.

Documentation Requirements

Parents seeking Section 7 expense orders or reimbursement must provide comprehensive documentation supporting both the expense amount and its qualifying nature:

  • Receipts or invoices showing the service provider, date, amount, and services rendered
  • Insurance explanation of benefits statements showing the amount covered and remaining balance
  • Professional recommendations or prescriptions supporting medical necessity
  • Income documentation establishing each parent's proportional share
  • Calculations showing the net expense after insurance reimbursement and any tax benefits

Filing for Health Insurance Child Support in British Columbia

Parents can establish health insurance child support British Columbia obligations through BC Supreme Court for divorcing couples or BC Provincial Court for all families regardless of marital status. The Supreme Court charges $200 for a Notice of Family Claim or $210 when combined with a divorce application, reflecting the $10 federal Registration of Divorce Proceedings fee. Provincial Court charges no filing fees for family law matters, making it the more affordable option for parents focused solely on child support without property division claims.

To file in BC Supreme Court, parents must complete Form F3 (Notice of Family Claim) specifying the relief sought, including child support under the Guidelines and proportional sharing of Section 7 expenses. The claim should identify specific expense categories anticipated, such as medical and dental insurance premiums, and request an order requiring ongoing proportional contribution to future expenses. Under BC Supreme Court Family Rules, Rule 4-1, the filed documents must include financial statements disclosing each party's income, expenses, assets, and liabilities.

Residency and Jurisdictional Requirements

At least one spouse must have been habitually resident in British Columbia for at least one year immediately before filing a divorce application, as required by Divorce Act, s. 3(1). For child support claims under the provincial Family Law Act, the court has jurisdiction if the child ordinarily resides in British Columbia or if both parents consent to BC jurisdiction. "Habitually resident" means the province constitutes your established home, though Canadian citizenship or permanent residency is not required.

Modifying Health Insurance Provisions in Existing Orders

British Columbia law permits modification of child support orders, including Section 7 expense provisions, when circumstances change materially from those existing at the time of the original order. Under Divorce Act, s. 17, either parent may apply to vary a child support order if a change in circumstances would result in a different order. Common grounds for modification include changes in either parent's income, changes in insurance coverage availability, new health conditions requiring treatment, or children aging out of dependent status.

The 2025 update to the Federal Child Support Tables, effective October 1, 2025, constitutes a change in circumstances that may justify variation applications. The updated tables raised the income threshold below which no base support is payable from $13,000 to $16,000 and adjusted amounts across all income levels. Parents with orders predating October 2025 may seek variation to align ongoing support with current table amounts, though the change in tables alone may not affect Section 7 expense sharing calculations unless parental incomes have also shifted.

Enforcement of Health Insurance Support Obligations

British Columbia provides robust enforcement mechanisms for child support orders, including Section 7 expense obligations, through the Family Maintenance Enforcement Program (FMEP). Once registered with FMEP, child support orders including ongoing Section 7 contributions become subject to automatic enforcement measures including wage garnishment, driver's license suspension, passport denial, and property liens. Under Family Maintenance Enforcement Act, s. 22, FMEP can intercept federal payments including tax refunds and employment insurance benefits to satisfy arrears.

For Section 7 expenses requiring one-time or periodic reimbursement rather than ongoing monthly payments, enforcement may require returning to court if the paying parent refuses to contribute their proportional share. Parents should include specific enforcement provisions in their separation agreements or court orders, such as requiring submission of expense claims within 30 days of payment with reimbursement due within 14 days of receipt.

Special Considerations for Self-Employed Parents

Determining income for self-employed parents requires careful analysis under Federal Child Support Guidelines, s. 16-19, which permit courts to adjust reported business income to reflect actual earning capacity. Courts may add back personal expenses claimed through the business, non-arm's length transactions, or excessive depreciation to arrive at income available for child support purposes. The proportional sharing calculation for Section 7 expenses uses the same adjusted income figure, meaning self-employed parents cannot reduce their share by understating income through business deductions.

British Columbia courts have extensive experience scrutinizing self-employment income in family law matters. Under s. 17-19 of the Guidelines, judges can impute income based on earning capacity if a parent is intentionally underemployed or unemployed, or if income patterns suggest manipulation to reduce support obligations. Both parents should disclose three years of business financial statements, corporate and personal tax returns, and GST filings when self-employment is involved.

Comparison: Medical Expenses Inside vs. Outside Table Support

Expense TypeCovered by Table AmountSection 7 (Shared Proportionally)
Over-the-counter medicationsYesNo
Basic prescription copaysYesNo, unless exceeding $100/year above insurance
Insurance premium (child portion)NoYes
OrthodonticsNoYes
Counselling/therapyNoYes
Glasses and contactsNoYes, if exceeding $100/year above insurance
Speech therapyNoYes
Hospital parking for routine visitsYesNo
Medical travel for specialistsMaybeYes, if exceeding $100/year
Dental cleanings (insured)YesNo
Dental procedures (uninsured balance)NoYes, if exceeding $100/year

Tax Treatment of Health Insurance Payments

Child support payments, including Section 7 expense contributions, are neither tax-deductible for the paying parent nor taxable income for the receiving parent under Canadian tax law, regardless of the specific expense category. This treatment applies equally to base table amounts and proportional Section 7 contributions for insurance premiums or medical treatments. The Canada Revenue Agency permits medical expense tax credits for eligible health costs, but only the parent who actually pays the expense (rather than the one receiving reimbursement) can claim the credit.

When calculating net Section 7 expenses for proportional sharing, courts deduct available tax credits from the gross expense to determine the actual cost borne by the parents. If a $3,000 orthodontics expense generates a $450 medical expense tax credit, the net expense for sharing purposes is $2,550. Parents should include tax benefit adjustments in their expense reimbursement calculations to ensure accurate proportional sharing.

Frequently Asked Questions

What qualifies as a Section 7 medical expense in British Columbia?

Section 7 medical expenses include the child-attributable portion of medical and dental insurance premiums plus any health-related expenses exceeding insurance coverage by at least $100 annually. Under Federal Child Support Guidelines, s. 7(1)(b) and (c), qualifying expenses include orthodontics, counselling, physiotherapy, occupational therapy, speech therapy, prescription medications, hearing aids, glasses, and contact lenses. Both parents share these costs proportionally based on their respective incomes.

How do I calculate my share of children's health insurance premiums?

Divide your gross annual income by the combined gross income of both parents to determine your percentage share. If you earn $60,000 and your co-parent earns $90,000, your share equals 40% ($60,000 ÷ $150,000). Apply this percentage to the net premium cost after deducting any employer contributions. For a $300 monthly premium where the employer pays $100, the net cost of $200 monthly ($2,400 annually) would be split $960 to you (40%) and $1,440 to your co-parent (60%).

Do children lose MSP coverage when parents divorce in British Columbia?

No, children's MSP coverage continues automatically after parental separation or divorce. However, children can only be enrolled on one parent's MSP account, requiring coordination about which parent maintains the enrollment. The parent removing children must ensure coverage exists under the other parent's account. MSP provides basic physician and hospital services at no premium cost to all British Columbia residents regardless of family status changes.

What happens if my co-parent refuses to pay their share of medical expenses?

You can enforce Section 7 expense orders through BC Supreme Court or Provincial Court by filing an application for enforcement. For ongoing obligations, register the order with the Family Maintenance Enforcement Program for automatic collection measures including wage garnishment. For individual expense reimbursements, document the expense with receipts and insurance statements, provide written notice to your co-parent of the amount owing, and return to court if payment is not received within a reasonable time.

Can I claim health insurance costs if we have shared parenting time?

Yes, Section 7 expenses apply regardless of parenting arrangements. Under shared parenting time (each parent has at least 40% of parenting time), base child support follows a set-off calculation where each parent's table amount is calculated and the higher-income parent pays the difference. Section 7 expenses remain separate and continue to be shared proportionally to income. The shared parenting arrangement affects only base support, not the proportional division of special expenses.

How are medical expenses handled when both parents have insurance coverage?

British Columbia follows the coordination of benefits birthday rule: claims go first to the plan of the parent whose birthday falls earlier in the calendar year. The secondary plan then covers remaining eligible expenses. Neither plan's coverage affects the proportional sharing of premiums as Section 7 expenses. Both parents' premium contributions (the child-attributable portion) are added together and then divided proportionally to income, with credits given for amounts already paid.

What if I cannot afford my proportional share of medical expenses?

Courts consider parental means when assessing Section 7 expense claims. Under Federal Child Support Guidelines, s. 7(1), expenses must be "reasonable in relation to the means of the spouses" to qualify for sharing. If an expense would cause undue hardship given your financial circumstances, you may apply to court for a departure from standard proportional sharing. Provincial Court, which charges no filing fees, offers a more accessible forum for modifying expense arrangements.

Do Section 7 medical expenses continue after a child turns 19?

Yes, Section 7 expenses continue for adult children who remain dependent due to full-time education or disability. Under Divorce Act, s. 2(1), a "child of the marriage" includes anyone over the age of majority who cannot withdraw from parental charge due to illness, disability, or pursuit of reasonable education. Health insurance premiums and medical expenses for adult dependent children remain subject to proportional sharing until the child becomes self-supporting.

How quickly must my co-parent reimburse me for medical expenses?

Separation agreements and court orders should specify reimbursement timelines, typically requiring payment within 14-30 days of receiving documented expense claims. Without specific terms, courts expect reasonable promptness, generally meaning payment within 30 days. Submit expense documentation including receipts, insurance explanation of benefits, and your calculation of the co-parent's proportional share. Keep copies of all submissions and follow up in writing if payment is not received.

Can I include mental health treatment in Section 7 expenses?

Yes, professional counselling provided by psychologists, psychiatrists, social workers, and other qualified mental health professionals explicitly qualifies under Federal Child Support Guidelines, s. 7(1)(c). Treatment costs exceeding $100 annually beyond insurance coverage are shared proportionally between parents. Courts recognize the importance of children's mental health and routinely approve sharing of therapy costs, residential treatment programs, and specialized assessments when professionally recommended.

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Written By

Antonio G. Jimenez, Esq.

Florida Bar No. 21022 | Covering British Columbia divorce law

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