Before you start

Permanent resident, work permit or study permit status of sufficient duration
Proof of BC residency
Identity documents for every family member
Private interim insurance covering the waiting period

Step-by-step

1
Buy private cover before you fly
The MSP waiting period is genuinely uninsured time and Canadian medical costs are high without coverage. Interim private policies are inexpensive relative to the risk and are far easier to arrange before departure than after arrival.
OnlineWho: YouBefore departure
2
Apply for MSP as soon as you arrive
Do not wait until the coverage date approaches. Apply through Health Insurance BC with your immigration documents and proof of address, and enrol every family member on the same application.
OnlineWho: YouWeek 1
3
Register with the Health Connect Registry for a family doctor
British Columbia has a shortage of family physicians and the provincial registry is the formal route onto a waiting list. Register immediately even though you may wait a long time — the wait starts when you register, not when you need one.
OnlineWho: You
4
Learn where the walk-in clinics and urgent care centres are
Until you have a family doctor, walk-in clinics and Urgent and Primary Care Centres are how routine care happens. They fill their daily capacity early. Emergency departments are for emergencies and the waits reflect that.
In personWho: You
5
Arrange extended health cover for what MSP does not include
Prescriptions outside hospital, dental, vision, physiotherapy and mental health services are not covered. Most employers provide an extended plan; if yours does not, buying one privately is worth it, and the province's Fair PharmaCare programme covers prescription costs above an income-based deductible once you register for it.
Via employerWho: You
6
Know that ambulance transport is billed
Even with MSP, an ambulance ride carries a charge in British Columbia. It is not large by American standards but it surprises people who assume public healthcare means everything is free at the point of use.
In personWho: You

Documents you’ll need

Passport and immigration document
Proof of BC address
MSP personal health number, once issued
Private insurance policy covering the waiting period
Records of prescriptions and conditions from your previous country

Things most newcomers don’t know

The MSP waiting period is real uninsured time and people routinely fly without cover for it.

Coverage starts after the balance of the month you arrive plus two more months, which for someone landing on the 2nd of a month is nearly three months exposed. Canadian healthcare is expensive when you are paying directly — a single emergency department visit with imaging runs into thousands. Interim private cover is cheap by comparison and much easier to buy before departure than from inside Canada.

Source: BC Ministry of Health

British Columbia's shortage of family physicians means waits measured in many months. The Health Connect Registry is the formal queue and your position depends on when you joined it. Registering immediately, before you have any medical need, costs ten minutes and is the single most useful piece of healthcare admin a newcomer can do. Almost nobody does it in week one.

Source: BC Ministry of Health

Public health cover here does not mean free at the point of use for everything.

MSP covers physicians and hospitals. It does not cover prescriptions taken at home, dental care, eye tests for most adults, physiotherapy, or ambulance transport — all of which people arriving from the UK or much of Europe reasonably assume are included. Dental in particular is a significant uninsured cost for anyone without an employer plan.

Source: BC Ministry of Health

Fair PharmaCare has to be registered for, and it is income-tested.

The provincial drug programme covers prescription costs above a deductible calculated from your income, but it does not apply automatically — you have to register, and registration requires a Canadian tax filing history the province can look at. Newcomers in their first year often have neither, which means paying full price for prescriptions during exactly the period when money is tightest.

Source: BC Ministry of Health