Medical Transportation Benefits Information

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Questions and Answers

What Medical Transportation Benefits are covered by the NIHB Program?

The Non-Insured Health Benefit (NIHB) Program may provide assistance so you can access eligible, medically necessary health services that cannot be obtained in the community of residence.

This may include assistance with meals and accommodation expenses.

Access to medical transportation benefits requires approval in advance by the Health Canada regional office, except in emergency situations.

What types of health services can I access using Medical Transportation?

Medical Transportation benefits may be provided to help you to access the following types of services:

• Provincial/territorial insured medical services (e.g. doctors' appointments, hospital care, health programs provided to all provincial residents);
• Eligible Non-Insured Health Benefits approved by the NIHB Program; and
• Alcohol, solvent, drug abuse and detox treatment pre-approved by the NIHB Program.

What conditions must be met in order to access NIHB Medical Transportation Benefits?

If you are an eligible NIHB client, the following conditions apply:

• The medical service you require is not available locally;
• You have first used up all other transportation benefits available from other federal, provincial/territorial or private programs;
• Travel is to the nearest appropriate health facility only;
• The most economical and efficient means of transportation is used, taking into consideration the urgency of the situation and the client's medical condition;
• Transportation to health services is coordinated to ensure maximum cost-effectiveness; and
• Benefits must be pre-approved by the Health Canada regional office or can be approved after the fact if there is medical justification and it meets NIHB Program criteria.

Will NIHB cover Medical Transportation to a medical appointment near my home?

No. NIHB does not cover Medical Transportation to access appointments within your home community.

Does NIHB cover escorts for Medical Transportation travel?

The NIHB Program will cover eligible travel costs for medical or non-medical escorts in certain circumstances:

• Medical Escort: When a physician or a registered nurse is needed to monitor the condition of the client's health during travel.
• Non-Medical Escort: A non-medical escort may be covered at the request of a health professional.
  • Examples of situations that may require a Non-Medical Escort
  • The client has a physical/mental disability such that he or she cannot travel without help;
  • Is medically incapacitated;
  • Is a minor and needs to be accompanied;
  • Requires legal consent by a parent or guardian; or
  • Requires a translator, if translation services are not available at the health facility.

Does NIHB cover compassionate travel?

No. Medical Transportation for compassionate travel is not a benefit (exclusion) under the NIHB Program.

When would the NIHB Program cover meals and accommodations?

Assistance with meals and accommodations may be provided while in transit to access medically necessary health services. Please contact the Health Canada regional office for more information on coverage and rates.

Is there an Appeal Process when a benefit has been denied?

A client, parent, legal guardian or representative may initiate an appeal when an eligible benefit has been denied by the NIHB Program.

For a case to be appealed, a signed note or letter from the client, parent or legal guardian, accompanied by supporting information from the service provider or prescriber (e.g. doctor) must be submitted to the NIHB Program. There are three levels of appeal available.

For for more information on the appeal process refer to the Appeal Process Section or contact the Health Canada regional office nearest you.

I was injured while on vacation in another province/territory. Will NIHB arrange Medical Transportation to transfer me back to my home province/territory?

No. The NIHB Program does not cover transportation to a home community when an injury has caused the cancellation of a trip or transfer clients between hospitals, within a province/territory or from one province/territory to another.

How does NIHB respect my privacy?

Health Canada's Non-Insured Health Benefits Program is committed to protecting clients' privacy and safeguarding the personal information in its possession. When a benefit request is received, the NIHB Program collects, uses, discloses and retains an individual's personal information according to the applicable federal privacy legislation.

Where can I find more information on the Medical Transportation Benefits covered by the NIHB Program?

More information about the Medical Transportation Benefit is available on the Medical Transportation fact sheet page of the HC Website  or contact your nearest Health Canada regional office.

Medical Transportation Benefit information can also be found under the Benefit Information section of Health Canada's NIHB website.

How do I contact the Health Canada regional office in my area?

A complete list of Health Canada regional offices is available on the Health Canada Website.

Resources

Distribution of NIHB Medical Transportation Expenditures ($ millions) - 2011/12

Source: Framework for Integrated Resource Management System (FIRMS) adapted by Program Analysis Division

For more information on NIHB medical transportation benefits provided, see the Non-Insured Health Benefits Program Annual Report 2011/2012.

Medical Transportation Policy Framework
The Non-Insured Health Benefits Medical Transportation Policy Framework outlines the policies and benefits that help recipients access medical services, the types of medical travel eligible for coverage and the benefits provided.

Medical Transportation Bulletins
The Non-Insured Health Benefits Medical Transportation Bulletins are published as required to inform providers of updates regarding the provision of transportation benefits to eligible recipients.

Medical Transportation Contribution Agreement Reporting Requirements

Medical Transportation Fact Sheet

Visit the Reports and Publications section to access a wide variety of Non-Insured Health Benefits documents.