Navigating Non-Insured Health Benefits (NIHB)
- IFNA
- Jan 9
- 3 min read
The Non-Insured Health Benefits (NIHB) Program provides eligible First Nations individuals with coverage for certain medically necessary health services and items that aren’t covered by provincial programs or private insurance. NIHB helps make sure families can access essential health-related supports, especially when those services aren’t available locally or aren’t fully covered under OHIP.
NIHB isn’t meant to replace the provincial system, it fills in the gaps so individuals can receive the care they need.
Determine if you are Eligible:
A client must be a resident of Canada, and one of the following:
a First Nations person who is registered under the Indian Act - commonly referred to as “Status”/Holds a valid Status Card
a child less than 2 years old whose parent is an NIHB-eligible client
Using your status card as identification at your healthcare providers office, hospital or pharmacy - they will bill directly to NIHB. Ensure they are aware of Status before your appointment, procedure or medications are ordered.
If your provider does not bill NIHB directly, you will be required to pay the provider up front and submit a request to NIHB for reimbursement of eligible benefits.
NIHB Pre-Approval:
Contact local NIHB office
Obtain a referral for services needed from a Doctor, Nurse Practitioner or other NIHB medical professional
Fins specific document for service needed on Express Scripts Canada
Send all required forms, including any additional insurance (such as through an employer) via mail to local NIHB office or online through your Express Scripts Canada account
Wait for approval or request for further information
Once approved, vouchers for transportation, accommodations, and meals will be sent to you for specific amounts/location.
One escort may be approved, two in special situations.
Book for travel at least 10 days prior to travel, following up 3 business days before date of travel
What NIHB Can Cover
Coverage depends on the person’s needs and on provider approval. Here are the main benefit areas:
Medications and Medical Supplies
Prescription drugs
Some over-the-counter medications when approved
Medical supplies and equipment (e.g., walkers, mobility aids, respiratory equipment, hearing aids)
Dental Care
Preventive care
Restorative treatments
Emergency dental services
Vision Care
Eye exams
Eyeglasses or lenses when eligible
Repairs or replacements when medically required
Mental Health Support
Short-term mental health counselling
Crisis intervention sessions
Medical Transportation
Travel to medical appointments when services aren’t available in the community
Accommodations and meals when approved
If a service or item is medically necessary and not covered elsewhere, NIHB may be able to help.
Medical Transportation Reimbursement
Select the "Client Reimbursement Request for Medical Transportation" form on Express Scripts Canada
Print and complete the form, along with receipts/documents supporting and send it in to your NIHB Regional Office or upload via your Express Scripts Canada account.
Services, Goods, Accommodations, Other Reimbursement
Gather all original receipts and documents associated with the travel/appointment (including food, gas, hotel, etc.)
Submit completed form, “General NIHB Reimbursement form” alongside receipts and supporting documents to your local NIHB office or through Express Scripts Canada.
Examples of medical reimbursement appointments: Vision, Mental Health Counseling, Pharmacy.
How IFNA Can Support You
Support from Mackenzie Stuart, Indigenous Transitions Facilitator at IFNA, is available. Help with advocating for needs, support with application process, reimbursement claims and navigation of healthcare systems to retrieve medical referrals, escort support and follow-up. For support, contact mstuart@ifna.ca
Support is available within local healthcare facilities. Reception at various medical clinics, Indigenous Care Coordinators at THBRHSC and Indigenous Health Associates at St. Joes.
ISC Forms by Category
Ontario Contacts
Non-Insured Health Benefits
1455-10 Wellington Street
6604 E Gatineau QC K1A 0H4
Client information line
Telephone (toll free): 1-800-640-0642
Fax (toll free): 1-800-806-6662
Medical supplies and equipment, vision care (including eyewear), mental health counselling (vendors and providers only)
Telephone (toll free): 1-800-881-3921
Medical transportation (Ottawa office)
Telephone (toll free): 1-800-881-3921
Telephone (after hours – toll free): 1-833-675-3081
Medical transportation (Sioux Lookout office)
Telephone (toll free): 1-888-283-8885
Emergency after hours (weekdays after 4 pm, weekends and statutory holidays)
Telephone (toll free): 1-833-675-3081
Medical transportation (Thunder Bay office)
Telephone: 1-807-343-5390
Telephone (toll free): 1-877-779-7749
Emergency after hours (weekdays after 4 pm, weekends and statutory holidays) Telephone (toll free): 1-833-675-3081
Medical transportation discharge travel for NIHB clients with community of residence in the Sioux Lookout area provided by Sioux Lookout First Nations Health Authority discharge (clients discharged from Manitoba and Ontario)
Telephone (toll free): 1-833-633-8728
NIHB Call Centre at Express Scripts Canada
Client inquiries
Telephone (toll free): 1-888-441-4777
Claims submission
Fax (toll free): 1-888-249-6098
SMS service for clients with a hearing or speech disability
Telephone: 1-289-302-8770
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