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First Nations & Inuit Health

Benefits Information

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 counselling, dental care, vision care, and medical transportation.

On this page:

Benefit Criteria

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 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.

Eligible Client Population by Region - March 2013

Eligible Client Population by Region - March 2013

Source: Status Verification System (SVS) adapted by Program Analysis Division

Client Reimbursement

Please be advised that the Government of Canada is switching from cheques to direct deposit for all government payments. To receive payments from Health Canada, you must enrol for direct deposit. You can apply for an exception if you do not have a bank account. Visit Direct Deposit for forms and information.

Service providers are encouraged to bill the Program directly so that clients do not face charges at the point of service when receiving health care goods or services.

When a client does pay directly for goods or services, he or she may seek reimbursement from the NIHB Program. If you have health coverage under more than one benefit plan, the claim should be submitted to the other plan first, and the NIHB Program will cover any remaining amount for eligible benefits.

Requests for reimbursement must be received on a NIHB Client Reimbursement Request Form, within one year from the date of service or date of purchase.

To obtain a print version of the NIHB Client Reimbursement Form, contact the nearest Regional Office, or a local First Nations and Inuit Health Authority.

Appeal Process

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

Audiology

Dental

Drug

Eye and Vision

Medical Supplies and Equipment

Medical Transportation

NIHB Program Information

Non-Insured Health Benefits Forms

Non-Insured Health Benefits Program Updates