Who is eligible for the Non-Insured Health Benefits program
Find out who can receive benefits under the Non-Insured Health Benefits (NIHB) program.
Who is eligible
To be 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 a "Status Indian")
- an Inuk recognized by an Inuit land claim organization as outlined in Inuit client eligibility for the NIHB program
- a child less than 2 years old whose parent is an NIHB-eligible client
To make sure that your child continues to be eligible for the program, you should apply as soon as possible for your child's:
- Indian status
- recognition from your Inuit land claim organization
Providers who have enrolled with NIHB (through the program's third party claims processor, Express Scripts Canada) are encouraged to submit claims directly, for services provided to NIHB clients, so that clients do not pay for eligible benefits at the point of service.
For clients to access benefit coverage, show your health care provider your client identification to confirm your eligibility with the program. Be sure to ask if the provider will be able to submit the claim for payment directly to Express Scripts Canada.
Coverage is available only for eligible goods and services obtained in Canada.
Some clients receive their health benefit coverage directly from a First Nations or Inuit government, community or health authority. This applies to:
- those served under self-government agreements or other arrangements, including Nisga'a (BC), Nunatsiavut (NL), Nunavik Inuit or James Bay Cree (beneficiaries living in the land claims region), and First Nations residents of BC who are clients of the First Nations Health Authority
- Bigstone Cree Nation (AB), which manages all NIHB benefits for their members
- Akwesasne (ON), which manages most NIHB benefits for their members
- clients served by other First Nations and Inuit communities or organizations that deliver some or all NIHB benefits directly to community members under a contribution agreement
Clients with questions about their eligibility should contact their NIHB regional office.
NIHB enrolled providers can find more information about client eligibility in section 4. Client Identification and Eligibility of the NIHB claims submission kits located on the Express Scripts Canada NIHB provider and client website.
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