Understanding Service Costs

The cost of most subsidized healthcare services is shared between the BC Ministry of Health and you. The amount you pay is called the client rate. It is based on your after-tax income, rates set by the Ministry of Health, and other factors.

Rates are adjusted each year by the Ministry of Health. Even if your circumstances stay the same, the amount you pay may change on January 1. 

Island Health will send you an annual letter with your updated subsidized service rate and any required actions. 

File your taxes by April 30 each year to keep your services. Not filing taxes may mean you lose service or pay more.

Service Specific Fees

Assisted Living Services

How your monthly rate is calculated

Single person: 70% of your after-tax income based on your annual Notice of Assessment from the Canada Revenue Agency (CRA).

Couples (married or common-law): 70% of your joint after-tax income if:

  • You both live in the same assisted living suite, and
  • One or both of you receive personal care services

Minimum and maximum rates apply. The maximum rate considers:

  • Market rent for housing
  • Hospitality services
  • Actual cost of assisted living services

A flat monthly rate applies if you receive Support and/or Shelter Allowance under the Employment and Assistance Act, or the Employment and Assistance for Persons with Disabilities Act.

Your monthly rate covers housing, hospitality, and personal care. Additional costs may apply (e.g., BC Hydro, phone, TV/internet connection, etc.).

Non-taxable income supports (e.g., BC Housing rent assistance, BC Bus Pass Program) do not affect your rate.

Eligibility Requirements

To qualify for a subsidized assisted living rate, you must:

  • Provide consent for the CRA to share your income information with the Ministry of Health (form provided by Island Health)
  • File your income tax with the CRA by April 30 each year
  • Sign the declaration, agreeing to pay the monthly subsidized assisted living rate

If requirements are not met, you will be charged the maximum assisted living rate.

Changes to Your Income

If your income is significantly and permanently lower than on your last Notice of Assessment:

  • Contact your Island Health Community Health Services Case Manager to discuss your eligibility for a revised monthly rate or the CRA office directly at 1-800-959-8281
  • New rate takes effect the first day of the month after recalculation
Home Support

Paying $0.00 Home Support

You do not pay a daily rate for home support services if you receive one of the following benefits. Let Island Health know if you receive:

  • Support and/or Shelter Allowance (age 18 to 64)
  • Guaranteed Income Supplement (GIS) for Seniors 65+
  • Guaranteed Income Supplement (GIS) for Couples
  • War Veterans Allowance through Veterans Affairs Canada

There is no charge for the following services:

  • Short-term Home Support: First two weeks may be free if you need short-term recovery support. If services continue beyond two weeks, an income-tested rate will apply
  • Home Support for End Stage Disease:
    • If you have a documented end-stage, life-limiting illness (life expectancy six months or less) and are registered for BC Palliative Care Benefits, you will not be charged for home support services
    • If your health status improves or stabilizes where it is no longer anticipated your life expectancy is six months or less, an income-test rate may apply

Paying a Subsidized Daily Rate for Home Support

  • Your daily subsidized home support rate is based on your income (and spouse’s income, if applicable)
  • Your daily rate is calculated by multiplying your “remaining annual income” (as defined in the Continuing Care Fees Regulation) by 0.00138889
  • You will never pay more than the actual cost of service even if your assessed rate is higher
  • If you are married or common-law and living together, and you both need service on the same day:
    • Both will receive an assessed daily rate
    • Only one of you will be charged that day for the home support service
  • If you or your spouse has earned income you will not be charged more than $300/month
  • Your allowable earned income must be reported each year to the Canada Revenue Agency on lines: 10100, 10400, 13500, 13700, 13900, 14100, 14300

Eligibility for Subsidized Home Support

To qualify:

  • Provide consent for Canada Revenue Agency to share your income info with the Ministry of Health. Consent form provided by an Island Health assessor
  • File taxes annually by April 30
  • Sign the declaration agreeing to pay your calculated daily rate

Other important information:

  • Rates are reviewed annually by the Ministry of Health (January 1). Even if your circumstances do not change, your rate might
  • If taxes are not filed, you may not be eligible for continued subsidized home support services
  • Non-taxable social assistance does not affect your rate
  • It is your responsibility to notify alternate payers (e.g., Veterans Affairs, WorkSafeBC) of your rate
  • For Choice in Supports for Independent Living, your daily contribution is calculated using the same income-tested calculation process as subsidized home support service

When Changes Occur to Your Income or Your Family Unit

If your income or household size changes (e.g., marriage, new child):

  • Contact Island Health Community Health Services for rate recalculation
  • New rate takes effect the first day of the month after recalculation
Long-Term Care

How Your Monthly Rate is Calculated

Single person: 80% of your after-tax income based on your annual Notice of Assessment from the Canada Revenue Agency (CRA).

  • If your after-tax income is less than $19,500 per year, your monthly rate = (after-tax income - $3,900) ÷ 12
    The $3,900 deduction ensures most clients keep at least $325/month after paying their rate.
  • If your after-tax income is $19,500/year or more, your monthly rate =
    (after-tax income × 80%) ÷ 12

Couples sharing a room: If both receive the Guaranteed Income Supplement (GIS) benefit at the married rate, your monthly rate is based on your after-tax income, otherwise you will be treated as two single people.

Minimum and maximum rates apply:

  • Minimum rate adjusts annually based on Old Age Security and Guaranteed Income Supplement
  • Maximum rate adjusts annually based the Consumer Price Index

A fixed monthly rate applies if you receive Support and/or Shelter Allowance under the Employment and Assistance Act, or the Employment and Assistance for Persons with Disabilities Act.

Your monthly rate covers the cost of secure, supervised housing, and care services.

Rates are adjusted by the Ministry of Health every year (January 1). Even if your circumstances don’t change, your rate might.

Eligibility Requirements

To qualify for a subsidized long-term care rate, you must:

  • Provide consent for Canada Revenue Agency to share your income information with the Ministry of Health (form provided by Island Health)
  • File your income tax with Canada Revenue Agency by April 30 each year
  • Sign the declaration agreeing to pay the monthly subsidized long-term care rate

If requirements are not met, you may be charged the maximum rate.

Pension Income Splitting

If you or your spouse use pension income splitting for tax purposes, this may affect your long-term care rate. For income splitting questions, contact the Canada Revenue Agency at 1-800-959-8281.

Changes to Your Income

If your income is significantly and permanently lower than on your last Notice of Assessment:

  • A member of the office staff at your long-term care residence to discuss your eligibility for a revised monthly rate or the CRA office directly at 1-800-959-8281
  • New rate takes effect the first day of the month after recalculation

Important Information for All Services

Receiving Support and Shelter Allowance (PWD) (IA)

If you receive Person with Disabilities (PWD) or Income Assistance (IA) through the Ministry of Social Development and Poverty Reduction (MSDPR):

  • Provide documentation to Island Health verifying you receive PWD or IA
  • Your subsidized rate will be set as follows:
    • Assisted Living: Flat monthly rate
    • Long-Term Care: Minimum monthly rate
    • Home Support: Daily rate set to $0.00
  • Assisted living and long-term care residents: sign the Facility/Residence Admittance form (HLTH 3319) to allow MSDPR to pay Island Health directly
  • File your taxes by April 30 each year to maintain eligibility

At age 65, PWD or IA ends. To remain eligible for your subsidized service:

  • File your taxes
  • Provide Island Health with your Notice of Assessment
  • Complete a financial assessment and sign the agreement to pay your rate
  • Update payment information with your care provider
  • At age 65, you may qualify for Old Age Security (OAS) and Guaranteed Income Supplement (GIS):
Help for Low-Income Seniors 65+ (Guaranteed Income Supplement)

If you are 65 or older and have a low income, you may qualify for the Guaranteed Income Supplement (GIS), a tax-free monthly benefit from Service Canada. GIS can help reduce or eliminate your client rate:

  • Assisted Living & Long-Term Care: GIS can help pay your monthly rate
  • Home Support: If you receive GIS, your daily home support rate is $0.00

How to Qualify

Proof Required

Island Health may ask for documentation showing you receive GIS (e.g., Service Canada letter) to adjust your rate.

GIS for Couples

If you are married or in a common-law relationship where you file taxes as a couple and your living arrangements change involuntarily due to health reasons beyond your control (for one or both of you), and either:

  • You currently receive GIS as a couple, or
  • One partner is low-income, and the other is high-income, but your combined income is above the GIS threshold

You may qualify for:

  • Individual GIS benefits, or
  • A higher Old Age Security (OAS) or GIS amount

To update eligibility:

Why This Matters: Changes in living arrangements can significantly affect your GIS and OAS benefits. Reporting these changes promptly ensures you receive the correct amount.

Shelter Aid for Elderly Renters (SAFER)

The Shelter Aid for Elderly Renters (SAFER) program helps make rents affordable for BC seniors with low to moderate incomes. SAFER provides monthly cash payments through BC Housing to subsidized rents for eligible BC residents who are age 60 or over.

The SAFER program is not available to individuals residing in Island Health subsidized housing, such as assisted living or long-term care.

See BC Housing | SAFER website for more information, as they manage the SAFER program.

Experiencing Financial Hardship

If paying your assessed rate causes serious financial hardship:

  • Speak with your Island Health Community Health Services Case Manager or the office staff at your living facility as temporary rate reductions may be available
  • You will need to provide evidence of financial hardship

Note: If Ministry of Social Development and Poverty Reduction pays your rate, you are not eligible for a temporary reduction.

Using a Pension Trustee (Assisted Living and Long-Term Care)

If you’ve been referred to The Bloom Group (TBG) or the Public Guardian and Trustee (PGT) of British Columbia to help manage your pensions, but they are not yet acting as your trustee:

  • You will be charged the minimum monthly rate until your income is confirmed
  • Once the Canada Revenue Agency gives them access, TBG or PGT will send your Notice of Assessment to:
    • Your Island Health Community Health Services Case Manager or your Long-Term Care Financial Administrator
  • Your income-tested rate will then be calculated
Free Tax Filing Resources

CRA offers free tax filing resources:

Government Resources
Printable Resources

General Information on Understanding Service Costs

Referral Required?
Not required

News & Events

There are no related News or Events