Non-Insured Health Benefits program for First Nations and Inuit: Dental benefits
Learn about dental benefits available to eligible clients under the Non-Insured Health Benefits (NIHB) program.
Important message
Information on this page is about NIHB program dental benefits for eligible First Nations and Inuit. If you are seeking information on the new Canadian Dental Care Plan, you can find it here: Canadian Dental Care Plan
On this page
About dental benefits
The NIHB program covers a range of dental services that are described in the NIHB Program for First Nations and Inuit: Dental Benefits Guide, including:
- diagnostic services, including:
- examinations
- radiographs (X-rays)
- preventive services, including:
- scaling
- polishing
- sealants
- fluorides
- restorative services, including:
- fillings
- crowns
- endodontic services, including root canal treatments
- periodontal services, including deep scaling
- removable prosthodontic services, including:
- partial dentures
- complete dentures
- oral surgery services, including extractions
- orthodontic services, including braces
- adjunctive services, including:
- sedation
- general anesthesia
The NIHB program provides eligible clients with coverage for eligible health benefits when not available through provincial or territorial health insurance, private insurance plans, or other publicly-funded plans or programs.
How to access dental benefits
Dental services must be provided in Canada, by a licensed dental professional, such as:
- dentist
- denturist
- independent dental hygienist
- dental specialist
Clients must make an appointment with a dental provider who will complete an examination, establish a treatment plan, and discuss the services required with the client.
The dental provider will indicate what is covered by the NIHB program. Certain services may need predetermination which is similar to a prior approval. If the provider does not know about the NIHB program, the client should contact the NIHB Dental Predetermination Centre and speak to dental benefit staff to determine what is covered.
Service providers who are enrolled with the NIHB program generally send in claims to the NIHB program directly. This means that clients should not have to pay when receiving their dental services, including any deductible or co-payment. Clients will need to show client identification in order for providers to bill the NIHB program directly.
Certain dental services are covered without predetermination (prior approval). For these services, the dental provider can provide the service and send the bill directly to the NIHB program.
For dental services that require predetermination, a request for coverage must be submitted to the NIHB program before receiving these services. This ensures both the client and provider are aware of the coverage decision.
Express Scripts Canada administers claims for providers on behalf of the NIHB program. Information can be found on the Express Scripts Canada NIHB Provider and Client Website, including:
- forms
- newsletters
- a dental claims submission kit
- a provider billing agreement
- regional dental benefit grids
Related links
- Appealing a decision under the NIHB program
- Claims and reimbursement under the NIHB program
- Contact the NIHB program
- Express Scripts Canada NIHB Provider and Client Website
- National Oral Health Advisory Committee (NOHAC)
- NIHB Program for First Nations and Inuit: Dental Benefits Guide
- NIHB program updates