Benefits Information - Non-Insured Health Benefits
Health Canada provides eligible First Nations and Inuit with coverage for a specified range of medically necessary health-related goods and services when not covered through private insurance plans or provincial/territorial health and social programs.
Non-Insured Health Benefits (NIHB) include prescription drugs, over-the-counter medication, medical supplies and equipment, mental health counselling, dental care, vision care, and medical transportation.
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A benefit will be considered for coverage when and item or service is:
- included on a NIHB Program benefit list or NIHB schedule;
- intended for use in a home or other ambulatory care settings;
- requested through the prior approval or predetermination process (when required);
- unavailable through any other federal, provincial, territorial, or private health or social program;
- prescribed by a physician, dental care provider, or other health professional licensed to prescribe; and
- provided by a recognized provider.
Who is an Eligible Client?
An eligible client is someone who is entitled to receive benefits such as vision care, prescription drugs or other benefits or services from the NIHB Program.
An eligible client must be identified as a resident of Canada and one of the following:
- a registered Indian according to the Indian Act;
- an Inuk recognized by one of the Inuit Land Claim organizations; or
- an infant less than one year of age, whose parent is an eligible client.
When clients are eligible for benefits under a private health care plan, or public health or social program, claims must be submitted to these plans and programs first before submitting them to the Non-Insured Health Benefits Program.
Providers are encouraged to enroll with the NIHB Program and bill the Program directly so that clients are not charged at the point of service.
Clients can seek reimbursement from the NIHB Program when paying directly for goods and services; however, it's recommended to contact the NIHB Program before paying to verify and specific criteria for health coverage. Also, it's important to find out whether the health provider is recognized by the Program.
Requests must be filled out using an NIHB Client Reimbursement Request Form and received by the Program within one year from the date of service or purchase to be eligible for payment.
Direct deposit payments are available through the Government of Canada. Visit Direct Deposit to enroll with Health Canada and receive electronic payments.
A client, their parent/legal guardian or representative may initiate an appeal when a benefit has been denied by the NIHB Program. In the event that they are unable, a client may have someone act on their behalf to initiate an appeal as long as written authorization is obtained from the person seeking coverage.
To initiate an appeal, a signed letter from the client, their parent/legal guardian or representative, accompanied by supporting information from a health care provider(s) or prescriber must be submitted to the NIHB Program.
A written explanation of the decision taken will be provided to the client or parent/legal guardian, at each level of the appeal process.
Refer to the Non-Insured Health Benefits Appeal Procedures for more information.
More Information and NIHB Program updates
Eye and Vision
- Vision Care Benefit - Policy Framework
- Vision Care Benefit List
- Eye and Vision Care Benefit Information - Questions and Answers
- New Vision Care Framework and Vision Care Benefit List - Questions and Answers
Medical Supplies and Equipment
- Medical Transportation Benefit Information - Questions and Answers
Mental Health Counselling
NIHB Program Information
- Non-Insured Health Benefits Program Annual Report 2012/2013
- Bill C-3 (McIvor) Questions and Answers
- Coordination of Benefits
- General Questions and Answers
- Qalipu Mi'kmaq First Nation Band Members
- Report on Client Safety
- Your Health Benefits - A Guide for First Nations to Access Non-Insured Health Benefits
- Your Health Benefits - A Guide for Inuit to Access Non-Insured Health Benefits
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