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Non-Insured Health Benefits (NIHB) Program | COVID-19 Questions and Answers

1.  During the COVID-19 pandemic, can I still access Non-Insured Health Benefits?

Yes, the NIHB Program continues to provide benefits and services.

The NIHB Drug Exception Centre, Dental Pre-Determination Centre and NIHB regional call centres continue to operate and receive calls, faxes and emails from clients and vendors. Claims processing services continue as usual.

2.  Should I travel to my non-urgent medical appointment?

NIHB clients are encouraged to consult with their health professional to confirm their appointments, and whether routine, non-urgent appointments should be postponed. NIHB will only cancel travel arrangements at the request of the health professional or the client. If the health professional determines the appointment must be attended, NIHB staff will work with the client to facilitate travel.

Many regions may have travel restrictions, or stay at home orders in place. Clients are encouraged to review local public health orders/guidance prior to travelling, and take all necessary precautions to reduce the risk of infection.

Some First Nation communities may have restrictions regarding re-entry into the community after travelling out, so travellers should discuss with their community Health Director or health centre before travelling, to ensure they are aware of any restrictions.

3.  Will NIHB cover my medical transportation expenses to attend my urgent or essential medical appointment, for example dialysis? 

Yes, NIHB continues to support clients who need medical transportation to access urgent or essential medical appointments. Where there is a medical need, vulnerable clients will be supported by covering private modes of transportation where necessary.

4.  Does NIHB cover medical transportation to get the COVID-19 vaccine?

Vaccination is being provided to all residents through the provincial or territorial health system.

In some cases, the COVID-19 vaccine is being transported into Indigenous communities to vaccinate residents. In the event NIHB clients need to travel out of their community of residence to get to their vaccination appointment, the travel is eligible under NIHB. Contact your NIHB regional office or your community’s MT coordinator to arrange your travel.

It is important to note that, in general, COVID-19 vaccination clinics are not open to the public. In order to receive the vaccine, clients must have an appointment with the clinic.

5.  Will NIHB cover the cost of transportation to get a COVID-19 test?

Yes. If COVID-19 testing is not available locally, and your health professional has advised you to get tested, medical transportation coverage may be provided.

6.  I am vulnerable due to my health condition. Will NIHB provide coverage for me to relocate temporarily, for example to a hotel, so I can be away from others that I live with?

If you do not have medical appointments, but a health professional or public health officials have advised you to stay in a location other than your home because of an underlying health condition, to reduce the risk of COVID-19, contact your community health centre or Health Director to determine what supports are available in your community.

The NIHB Program can provide you with support to travel to a designated isolation site if you have been accepted for admission.

For vulnerable clients who have an ongoing need to attend essential or urgent medical appointments, NIHB will continue
to provide coverage of your medical transportation, accommodation and meals. You may be eligible for temporary relocation to reduce your need to travel.

7.  I am vulnerable due to my health condition and cannot travel with, or be around, others. How can NIHB support me?

NIHB clients are encouraged to consult with their health professional to confirm whether routine, non-urgent appointments should be postponed. Where there is a medical need, vulnerable clients will be supported to use private modes of transportation where necessary.

Additional information regarding infection prevention/control measures was shared with transportation service providers for their information.

NIHB has advised partners that additional expenses for increased cleaning and sanitization measures are eligible administrative expenses under Contribution Agreements.

Boarding homes have been advised to take measures to support social-distancing and self-isolation, and that vulnerable people at higher risk for severe disease can be placed in facilities outside the boarding home, such as hotels, to limit exposure.

8.  My community is locked down and nobody is allowed in or out to prevent the spread of the virus. I am currently out of the community. Will NIHB pay for accommodation and meals for me to self-isolate for two (2) weeks before going home.

If you were out of your community on NIHB eligible medical travel, NIHB can extend your meals and accommodation coverage for an additional 14 days to enable you to self-isolate for that period before returning to your community.

If you were out of your community for any other reason (e.g. work-related travel, meetings, vacation) when the community went into lock-down, contact your community leadership, health centre or Health Director to confirm what actions you should take prior to returning home.

9.  My treating health professional has diagnosed me with COVID-19, or I am waiting for a test result because I may be infected. Can NIHB provide coverage for a hotel and meals for two (2) weeks, so that I can be away from others?

The Public Health Agency of Canada (PHAC) advises that if you have symptoms, have been diagnosed with COVID-19, are waiting for laboratory test results or have been advised to do so by Public Health you need to be isolated, which means to:

  • stay home until the local public health authority says you are no longer at risk of spreading the virus
  • avoid contact with others
  • If your symptoms get worse, immediately contact your healthcare provider and follow their instructions

In order to reduce your contact with others, The Public Health Agency of Canada advises that you:

  • isolate yourself at home for 14 days to avoid spreading it to others
  • if you live with others, stay in a separate room or keep a 2-metre distance
  • wear a mask
  • if you need to see your healthcare provider, call ahead to tell them your symptoms and follow their instructions

If you have been advised by a health professional to isolate somewhere other than your home, please contact your community leadership or Health Director to confirm what supports are available in your community. The NIHB Program can provide you with support to travel to a designated isolation site, if you have been accepted for admission.

10.  Am I eligible for NIHB medical transportation support when I am in mandatory quarantine/isolation?

The NIHB Program can provide you with support to travel to a designated isolation site if your health professional has referred you there and you have been accepted for admission.

Individuals who must attend repeated, essential medical appointments, or who must remain close to hospital during their quarantine/isolation period may be eligible to receive support for temporary relocation to the urban centre where the appointments will take place. The isolation site and local public health officials will determine how you access health services while you are in quarantine.

11.  The restaurant has closed in the hotel that I am staying at and only delivery by other restaurants is available- what do I do for meals?

In addition to NIHB meal allowance rates, NIHB will also provide coverage up to an additional $7.00 per meal, or $21.00 per day, for meal delivery charges, per family/group of travellers.

12.  How can I continue with my mental health counselling?

NIHB supports the delivery of mental health counselling by telephone or video. Contact your mental health counsellor to see if this is an option.

13.  Should I attend my dental appointment?

Dental professional organizations across Canada are monitoring provincial/territorial public health directives in regards to COVID-19 and will advise of any restrictions placed on provision of oral health services. Prior to attending a dental appointment, you are encouraged to contact your dental office to confirm it is taking place, and to discuss what to expect.

14.  Does NIHB cover fever and pain medication? What about thermometers?

NIHB covers a range of over-the-counter fever and pain medications for adults and children. These are open benefits and can be covered with a prescription from a doctor or nurse practitioner, or a written recommendation from a pharmacist.

For the duration of the pandemic, oral digital thermometers are covered so individuals can monitor their temperature as required. These are open benefits and can be covered with a prescription from a doctor or nurse practitioner, or a written recommendation from a registered nurse or pharmacist.

15.  I am hearing about potential drug shortages. Should I be concerned?

NIHB works closely with federal and provincial partners as well as distributors to monitor drug shortages. If a shortage occurs, NIHB can make quick policy changes to ensure other drugs are made eligible. This may take place by removing the prior approval requirements from alternative drugs or reimbursing compounded therapies.

16.  What plans are in place to support people who need access to treatment for opioid addiction?

In some jurisdictions such as Alberta and Ontario, regulatory bodies have permitted extra carries of methadone and Suboxone for certain clients, when deemed to be safe. NIHB has made the necessary system changes to allow larger quantities to be reimbursed.

17.  How do I obtain oxygen benefits?

The requirement for testing (ABG and oximetry) has been removed during the pandemic for clients applying for 9 month, 1 year or annual renewal for coverage of home supplemental oxygen (systems such as concentrators, portable cylinders, home fill systems, portable oxygen concentrators).

Note that initial requests for supplemental home oxygen continue to require testing results. The requirement for an ABG test is waived. Either oximetry or ABG testing is accepted. The Program may waive this requirement depending on the provincial/territorial criteria in place to respond to the pandemic.

18.  I need to replace my medical equipment or supply. What do I do?

If you are unable to get a new prescription for the replacement of equipment or supplies and your medical status has not changed, your Medical Supply and Equipment provider may use the existing prescription on file for the replacement of:

  • Limb and body orthotics
  • Custom made shoes
  • Medical grade compression stockings
  • Mobility equipment
  • Incontinence and ostomy supplies
  • Laryngectomy and tracheostomy supplies
  • Self-care benefits such as lifts, transfer equipment, dressing and feeding aids, and bathing and toileting aids.

The existing prescription must not be older than three years. Quantities above the current recommended replacement guidelines may be requested without medical justification, if required due to circumstances caused by the pandemic.

19.  Are there any special considerations for individuals who have COVID-19 and use Positive Airway Pressure (PAP) therapy?

Individuals who become infected with COVID-19 and continue PAP therapy when infected should obtain a new mask and tubing once they have recovered. Clients should ask their provider to contact NIHB as soon as possible for prior approval of new equipment and supplies.

20.  I need to access audiology benefits, but am unable to visit the audiology provider in person (e.g. due to vulnerable health status, community travel restrictions, etc.) What are my options?

Individuals who are unable to go to an audiology clinic may obtain certain audiology services through tele-audiology from audiology clinics that are set up to provide these services remotely.

The services that can be provided remotely include a hearing aid performance check and readjustment, and the fitting and dispensing of certain hearing devices such as hearing aids, bone-anchored hearing systems (BAHS) processor and replacement of cochlear implant processors. These hearing devices will be shipped directly to the client. The client must then make arrangements to schedule a virtual appointment for the first-fit.

21.  Can I have my eye glasses shipped to me?

As a temporary measure, vision care providers can bill NIHB for the cost of shipping eligible eyewear to clients who are unable or prefer not to visit the retail location. Let your eyewear provider know if you would like the item shipped to you so they can include the shipping cost in the prior approval request to NIHB.

22.  Am I still eligible for NIHB even though my Indian Status card has expired?

NIHB clients should not be denied services because their Indian Status cards have expired.

Health services providers and vendors require client identity information to bill NIHB for services provided to you. If you are a registered First Nations person, providers may ask to see your Indian status card because your Indian status registration number is also your NIHB client identification number. The number remains valid even if the card has expired.

Services providers/vendors can call Express Scripts Canada to verify client eligibility. For medical transportation benefits, contact the NIHB regional office.

23.  Do unregistered infants have coverage under NIHB?

Yes. In order to allow time for parents to register their infant children for First Nation status, NIHB provides coverage for unregistered infants with at least one NIHB-eligible parent.

During the COVID-19 pandemic, there may be delays in registration. Therefore, NIHB has extended coverage of unregistered infants up to 24 months of age until further notice (extended from 18 months, previously). Infants up to 18 months of age may already access most types of NIHB benefits under the identification number of their parent or guardian who is NIHB eligible.

Starting at 18 months of age, a child needs his or her own status or N number to process NIHB benefits. If your child has reached the age of 18 months and is not registered, please call your NIHB Regional Office, or the Drug Exception Centre if your request is related to pharmacy benefits/medication. You will be provided with a temporary NIHB client number that is valid until your child reaches 24 months of age.

 

Helpful Contact Information:

NIHB Contact Information:

  • Pharmacy Benefits: NIHB Drug Exception Centre 1-800-580-0950 ext. #3
  • Dental and Orthodontic Services: NIHB Dental Predetermination Centre 1-855-618-6291 (Dental Services), 1-866-227-0943 (Orthodontic Services)
  • For other benefit areas, contact your NIHB regional office. Contact information can be found at online at: Canada.ca/nihb-contacts

Express Scripts Canada:

  • NIHB Client Call Centre 1-888-441-4777
  • For assistance with services provided by Express Scripts Canada, including NIHB client web accounts and submission of client reimbursement requests for pharmacy, dental, MS&E, vision care and mental health counselling benefits