BC Long-Term Care Co-Payment Calculation

How the Calculation Works

British Columbia does not charge a flat rate for subsidized long-term care or assisted living. The monthly co-payment is income-tested — calculated from the parent's after-tax income as reported on their Canada Revenue Agency Notice of Assessment.

The formula is different for each level of care:

Long-term care: For annual after-tax income below $19,500, the monthly rate is the income minus $3,900, divided by 12; at $19,500 or more, it is 80% of annual after-tax income, divided by 12. The minimum monthly rate is $1,507.70 and the maximum is $4,142.60. Residents must retain a personal needs allowance of at least $325 per month.

Assisted living: 70% of the parent's annual after-tax income, divided by 12. The minimum monthly rate is $1,070.90. The maximum is determined by the market housing rent for the geographic region plus the cost of personal care services.

Subsidized home support: A tiered daily rate based on adjusted annual income. Under $28,000: $0 per day. $28,000 to $35,000: $4.40 per day. $35,000 to $45,000: $13.40 per day. $45,000 to $55,000: $22.60 per day. $55,000 to $70,000: $32.20 per day. Over $70,000: $41.80 per day (the maximum cap).

These rates are set by the Continuing Care Fees Regulation under the Continuing Care Act and are updated periodically by the Ministry of Health.

What Counts as Income

The health authority uses the parent's after-tax income, as verified by the CRA Notice of Assessment. This can include:

• Canada Pension Plan and Old Age Security payments
• Private pension income (employer pensions, annuities)
• RRIF minimum and excess withdrawals
• Interest, dividend, and investment income
• Rental income
• Employment income (if any)

The parent's assets — savings accounts, property equity, investment portfolio balances — are not included in the calculation. BC's care fee system is income-based, not means-tested. A parent sitting on a $2 million home and a $500,000 investment portfolio but reporting $35,000 in annual pension income will pay the rate corresponding to $35,000.

Couples and Income Attribution

For long-term care, when one spouse enters care and the other remains in the community, the calculation uses the care resident's applicable income. Assisted living can use combined income when the clients live as a couple. Pension splitting can affect the income figures used, so the applicable formula should be confirmed with the health authority.

For GIS-receiving couples where both spouses are in the same long-term care facility and share a room, a special rate of $1,039.17 per person per month applies.

The Notice of Assessment Trap

The most expensive mistake families make is failing to file the parent's taxes or losing the Notice of Assessment. If the health authority cannot verify the parent's income, they are legally required to charge the maximum rate — $4,142.60 per month for LTC.

This is not a penalty. It is the regulatory default. The maximum rate can continue while the family obtains the Notice of Assessment; once the authority receives it, ask for the rate to be recalculated under the applicable rules. During the months the family is scrambling to file (especially if CRA authorization has not been set up), they may be paying the maximum out of pocket or accumulating arrears.

How to Reduce the Co-Payment

File taxes early. The health authority requests the Notice of Assessment annually. Filing before April 30 ensures the correct rate is applied from the start of the assessment period.

Review the income figure. The care-fee calculation uses the adjusted after-tax income shown through the CRA Notice of Assessment. Review the return and NOA with a tax professional, but do not assume that a tax item reduces the care fee dollar for dollar.

Use pension splitting. If the parent has a spouse in the community, splitting up to 50% of eligible pension income to the spouse may reduce the income used in the care-fee calculation. The tax and care-fee effects should be modelled together.

Apply for a Temporary Rate Reduction. If paying the assessed rate causes genuine financial hardship — the parent or their spouse cannot afford adequate food, housing, utilities, or prescribed medications — the family can apply for a TRR through the case manager. The application requires documenting monthly expenses, and the health authority must process it within 30 business days. Once approved, the reduced rate is backdated to the application date and lasts up to one year.

Restructure RRIF withdrawals. Since RRIF income counts toward the care fee calculation, withdrawing only the mandatory minimum (rather than excess amounts) keeps reported income lower. If the parent needs cash from their RRIF for expenses beyond care, evaluate whether the additional withdrawal's impact on the care rate, subject to the applicable maximum, outweighs the cash benefit.

What the Rates Cover

Long-term care rates include accommodation, meals, 24-hour nursing care, personal care (bathing, dressing, mobility assistance), housekeeping, laundry, and recreational programming. They do not typically cover prescription medications (covered separately through PharmaCare), personal phone plans, clothing, haircuts, or discretionary expenses — which is what the $325 personal needs allowance is for.

Assisted living rates cover housing, hospitality services (meals, housekeeping, laundry), and personal care assistance. They do not include 24-hour nursing care, which is the primary distinction between assisted living and long-term care.

Our British Columbia Power of Attorney & Personal Directive Kit includes a care rate calculator worksheet and a step-by-step guide to the Temporary Rate Reduction application process.

See more British Columbia guides →