Non-Insured Health Benefits

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Non-Insured Health Benefits

Contact Name: Andrea Kilbride

Contact Number: (902) 831-2711

Contact Email: Andrea.kilbride@lennoxisland.com

The Non-Insured Health Benefits (NIHB) program provides medically necessary coverage for eligible First Nations and Inuit people in Canada.

This program is for eligible First Nations and Inuit clients who are not covered through other social programs, private insurance plans, provincial or territorial health insurance.

Who is eligible?

An eligible client must be a resident of Canada and any of the following:

  • a First Nations person who is registered under the Indian Act (commonly referred to as a status Indian)
  • an Inuk recognized by an Inuit land claim organization
  • a child less than 18 months old whose parent is a registered First Nations person or a recognized Inuk

To make sure that your child continues to be eligible for the program, you should apply for your child’s Indian status recognition from your Inuit land claim organization. This should be done as soon as possible.

We’re here to help.

The Lennox Island Health Centre works with the federal NIHB program on behalf of its clients.

We assist Lennox Island band members living on reserve and off reserve, as well as members of other bands who are living on Lennox Island.

Clients can call, drop in at the Lennox Island Health Centre or set up a meeting to get their questions answered about medical transportation, appeals, supplies.

Non-Insured Health Benefits also has a Toll Free line (1-800-565-3294) which anyone can call any time with questions or concerns.

We reimburse clients for their travel, accommodations, meals, supplies, medications.

What is covered?

The program provides coverage for the following medically necessary services and items:

Medical Transportation

The program may cover your medical transportation costs if you need to travel within Canada for medical care. This benefit covers the travel costs for you to attend medically necessary health services that are unavailable on-reserve. This means that the program may cover costs for medical services in other regions of Prince Edward Island and off-Island.

Medically necessary health services include medical services defined as insured services by provincial or territorial health plans, such as:

  • appointments with physicians,
  • hospital care,
  • diagnostic tests,
  • medical treatments,
  • alcohol, solvent, drug abuse and detox treatments,
  • traditional healers, and,
  • non-insured health benefits, such as vision, dental, and mental health counselling

Medical transportation benefits include:

  • travel costs, such as: bus, taxi, private vehicle
  • living expenses, such as meals and accommodations
  • emergency transportation, such as ambulance by air or ground

Medical transportation benefits may also be provided for an aide (also known as an escort) to travel with you. Coverage for escorts depends on certain requirements being met.

In some cases, the program may cover travel costs to bring health professionals into isolated communities to deliver health services.

Making a Benefit Claim

You will need to show client identification for healthcare providers to bill the program directly. We encourage providers to enrol with the program and submit claims directly, so clients avoid covering upfront costs.

Some health service providers bill the program directly through Express Scripts Canada. This website provides information on the claims administration and payment processes for providers of dental, pharmacy, medical supplies and equipment.

Where a client does pay upfront, the program accepts claims using the client reimbursement process.

Vision care and mental health providers can contact the NIHB regional office if they need more information. Medical transportation is also managed by the regional office.

A First Nations or Inuit community, self-government, or health authority may be responsible for providing some or all NIHB benefits.

Becoming a Medical Carrier

Interested in providing professional driving services for medical transport? The following is a list of criteria for becoming a Medical Carrier:

  • Copy of License
  • Copy of Motor Vehicle Inspection
  • Copy of Insurance
  • Copy of Registration
  • Letter of Proof of 6A Insurance
  • Vulnerable Criminal Record Check

Contact Name: Andrea Dyment

Contact Email: andrea.dyment@lennoxisland.com