Non-Insured Health Benefits

Notices

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Background

This NIHB program within Mohawks of the Bay of Quinte (MBQ) Administration has been in place for 25+ years. This community program’s role was deemed an immediate necessity after an urgent need was identified that a large number of community members were having significant difficulties navigating the health and medical services landscape in search of access to optimum health care. The decision by Tyendinaga Mohawk Council to provide a direct communication link between NIHB and the members of MBQ was established as a definite community investment. The MBQ NIHB program will provide support and advocacy for community members seeking health and medical services with NIHB funding coverage.

Overview

Key Contacts

Main NIHB Website: https://www.canada.ca/en/indigenous-services-canada/services/non-insured-health-benefits-first-nations-inuit.html
NIHB Client Contact Line: 1-800-640-0642 (toll-free)
NOTE: If a MBQ member resides outside of the Province of Ontario, they may need to contact their local regional NIHB Office to coordinate health/medical services with that particular provincial or territorial health system.

Indigenous Services Canada delivers the NIHB Program by providing funding coverage for a specified range of medically necessary health-related goods and services. This federal program is for eligible First Nations and Inuit clients in a coordinated effort with other social programs, private insurance plans, provincial or territorial health insurance. It is also very important to note that all possible health funding avenues must be explored and exhausted first as this federal funding program is deemed the payer of last resort. The program works as a local advocacy and information resource for First Nations individuals to have more knowledge of the health/medical system and a stronger understanding of their own role when accessing personal health, wellbeing and medical services. This program is designed to improve access to NIHB for registered First Nations by working along side them with health workers, service providers and a network of health/medical facilities. The program will constantly continue to identify community service issues, address NIHB policy barriers and ensure these challenges are documented and brought before the required individual or department for review.

Benefits Breakdown

Dental Benefits

The federal dental benefit covers dental services including diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, oral surgery, orthodontic and adjunctive services.

Medical Supplies and Equipment

The MS&E lists contain the products and services provided as eligible benefits by the NIHB Program, along with information pertaining to benefit codes, requirements for prior approval and applicable frequency limitations.

Mental Health Services

The program covers mental health counseling to provide support for an immediate mental health need. This is part of federal mental wellness programs for First Nations and Inuit members. These programs are linked to localized services provided by communities, provinces and territories.

Vision Care

The objective of the NIHB Program vision care benefit is to provide eligible clients with access to vision care benefits and services in a fair, equitable and cost-effective manner.

Medical Transportation

Medical transportation benefits are funded to assist First Nations clients to access medically required health services that cannot be obtained on the First Nation or in the community where the First Nations member permanently resides when access would otherwise be denied. Exceptions may be granted with justification and with First Nations and Inuit Health Branch (FNIHB) approval to meet exceptional needs.

Medications & Pharmacy

The Drug Benefit List (DBL) is a listing of the medications and therapies provided as a pharmacy benefit by the Non-Insured Health Benefits (NIHB) Program. The listed medications and therapies are those primarily used in a home or ambulatory setting. A prescription from a licensed practitioner is required for any listed medication or therapy to be processed as a federal benefit. A licensed practitioner is an individual that is authorized to prescribe medications within the scope of medical practice in their province or territory.