NIHB Handbook - First Nations Health Council

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NON-INSURED HEALTH BENEFITS (NIHB)What types of health benefits can a registered First NationsCitizen access under the NIHB program?BenefitsPage1. Eye and Vision Care 22. Dental 63. Medical Transportation 104. Drugs 145. Medical Supplies and Equipment 176. Crisis Counselling 207. Approved Health Services Outside of Canada 22More InformationProcedures for Appeals 24Consumer Rights in Health Care 27Your Information Rights 28First Nations & Inuit Health Branch (FNIHB) Regional Offices 32BackgroundThe Assembly of First Nations’ Health and Social Secretariat has a role to ensure thatall First Nations citizens, regardless of residence, have access to quality health servicesprovided by the First Nations and Inuit Health Branch (FNIHB) of Health Canada.http://www.afn.ca/article.asp?id=103First Nations, supported by AFN, assert that health benefits are an Inherent Aboriginal andTreaty Right and are constitutionally protected. Health services are to be comprehensive,accessible, fully portable, and provided as needed on a timely basis without regard to aperson’s financial status, residence, or the cost of benefit.The NIHB Program draws its authority from federal Cabinet approval of the 1979 IndianHealth Policy and the Non-Insured Health Benefits Renewed Mandate in 1997. FirstNations Inuit Health Branch may make changes to benefit policies at any point in time.
1. EYE AND VISION CARE BENEFITSWhat is covered?Payment is made to the provider in the areas listed below. All eye and vision care benefits requireprior approval.General eye andvision exams if notcovered by a private,federal or provincial/territorial health planSpecific Eye ExamsFollow-Up ExamsFirst pair of eyeglassesReplacementeyeglassesEyeglass repairsEvery two years for a person 18 years old and over.Every year for a person younger than 18 years.When there is a change or correction in vision.* A person with diabetes should schedule regular eye exams asrecommended by their doctor.May be approved by a FNIHB Vision Care consultant on a case bycase basis;When a severe abnormality in ocular or visual condition requires athorough assessment using specific tests.Specific eye exams for diabetics will be approved as part of this process.May be approved by a FNIHB Vision Care consultant on a case bycase basis;When required by certain ocular or visual conditions.Specific eye exams for diabetics will be approved as part of this process.With a written prescription from the doctor.Lenses and frames up to a maximum amount determined by the regionalFNIHB office.Lenses include: unifocal (distance or near vision), aspheric, bifocal, orhigh index (HIL). Some restrictions apply.Every two years for a person 18 years old and over.Every year for a person younger than 18 years.An accepted amount of change or correction in vision is required accordingto NIHB guidelines.Lenses include: unifocal (distance or near vision), aspheric, bifocal,or high index (HIL). Some restrictions apply.The total cost of the repair must not be more than it would costto replace with standard frames.Within a two year period for a person 18 years old and over.Within a one year period for a person younger than 18 years.The repairs will make the glasses usable.*Replacement frames or sets of lenses are not eyeglass repairs.2
Page 1 and 2: This handbook was developed by the
Page 3: AFN Health & Social Secretariat Man
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 and 18: 4. DRUG BENEFITSWhat is covered?Pay
Page 19 and 20: What is not covered/ExclusionsAnti-
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?

NIHB Handbook - First Nations Health Council

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