NIHB Handbook - First Nations Health Council
NIHB Handbook - First Nations Health Council NIHB Handbook - First Nations Health Council
Prior approvalPrior approval for a drug is needed in some cases.When a drug requiring prior approval is needed on an emergency basis, and timely accessto the Non-Insured Health Benefits Drug Exception Centre is not possible, a pharmacist maydispense an initial course of treatment for a maximum of four days.The pharmacist must contact the Drug Exception Centre as soon as possible for approvalto be back-dated to cover the emergency supply. Any further dispensing of the drug willfollow the usual prior approval process.Providers requesting prior approval of drug benefits on behalf of NIHB recipients may callHealth Canada’s NIHB Drug Exception Centre:Telephone (toll-free):1-800-580-0950Telephone (Ottawa): (613) 941-1558Fax: 1-800-281-5021Who can prescribe drugsRegistered PharmacistsLicensed Practitioners with authorization to prescribe within the scope of practice in theirprovince or territoryExceptions1. Drugs that are not listed in the Drug Benefit List may be approved for coverage on a caseby case basis when an exceptional need is demonstrated.2. This need must be established by the prescriber by completing an Exception DrugRequest form.3. “Limited use” drugs – have a established criteria which the individual must meet in orderfor the cost to be covered.4. Consideration for individuals who require more than the maximum allowable.5. Consideration for individuals who have experienced an adverse reaction with a best pricealternative drug, and a higher cost alternative is requested by the prescriber.15
What is not covered/ExclusionsAnti-obesity drugsHousehold products (e.g. soap & shampoos)CosmeticsAlternative therapies (e.g. glucosamine and evening primrose oil)Drugs with investigational/experimental statusMegavitaminsVaccinations for travel indicationsHair growth stimulantsFertility agents and impotence drugsSelected over-the-counter productsCodeine containing cough preparationsDarvon ® and 642 ® (propoxyphene)For additional informationReview the Drug Benefits at the address below.http://www.hc-sc.gc.ca/fnih-spni/nihb-ssna/benefit-prestation/drug-med/index_e.htmlCall your First Nations & Inuit Health Branch (FNIHB) regional office or a designatedFirst Nations health authority. Please refer to the contact list included on the page 32of this handbook.16
- Page 1 and 2: This handbook was developed by the
- Page 3 and 4: AFN Health & Social Secretariat Man
- Page 5 and 6: 1. EYE AND VISION CARE BENEFITSWhat
- Page 7 and 8: Trial of BifocalsTints and Coatingf
- Page 9 and 10: 2. DENTAL BENEFITSWhat is covered?P
- Page 11 and 12: Remember1. Prior approval or predet
- Page 13 and 14: 3. MEDICAL TRANSPORTATION BENEFITSW
- Page 15 and 16: Non-MedicalAddictions TreatmentOthe
- Page 17: 4. DRUG BENEFITSWhat is covered?Pay
- Page 21: Remember1. The rules about what is
- Page 24 and 25: What is not covered/ExclusionsPsych
- Page 26 and 27: What is not covered/ExclusionsAny b
- Page 28 and 29: Where to Submit an Appeal for Denta
- Page 30 and 31: CONSUMER RIGHTS IN HEALTH CARE1. Yo
- Page 32 and 33: Health Canada’s NIHB Privacy Code
- Page 34 and 35: NOTES31
- Page 36: Having Difficulty QUITTING Smoking?
What is not covered/ExclusionsAnti-obesity drugsHousehold products (e.g. soap & shampoos)CosmeticsAlternative therapies (e.g. glucosamine and evening primrose oil)Drugs with investigational/experimental statusMegavitaminsVaccinations for travel indicationsHair growth stimulantsFertility agents and impotence drugsSelected over-the-counter productsCodeine containing cough preparationsDarvon ® and 642 ® (propoxyphene)For additional informationReview the Drug Benefits at the address below.http://www.hc-sc.gc.ca/fnih-spni/nihb-ssna/benefit-prestation/drug-med/index_e.htmlCall your <strong>First</strong> <strong>Nations</strong> & Inuit <strong>Health</strong> Branch (F<strong>NIHB</strong>) regional office or a designated<strong>First</strong> <strong>Nations</strong> health authority. Please refer to the contact list included on the page 32of this handbook.16
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