Health Canada provides eligible First Nations people and Inuit with a specified range of medically necessary health-related goods and services when they are 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, short-term crisis counseling, dental care, vision care and medical transportation.
A benefit will be considered for coverage when:
The item or service is on a NIHB program benefit list or NIHB schedule;
It is intended for use in a home or other ambulatory care settings;
Prior approval or predetermination is obtained (if required);
It is not available through any other federal, provincial, territorial, or private health or social program.
The item is prescribed by a physician, dental care provider or other health professional licensed to prescribe; and
The item is provided by a recognized provider.
Who is an eligible recipient?
An eligible recipient 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 recipient 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 recipient.
When recipients are eligible for benefits under a private health care plan, 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, NIHB is payer of last resort.