Non-Insured Health Benefits program for First Nations and Inuit: Medical supplies and equipment benefits
Learn about medical supplies and equipment (MS&E) benefits available to eligible clients under the Non-Insured Health Benefits (NIHB) program.
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About medical supplies and equipment benefits
The program covers items that are included on the NIHB Program for First Nations and Inuit: MS&E Guide and Benefit Lists. These items must be:
- prescribed by an NIHB-recognized health professional listed in the NIHB MS&E Guide and Benefit Lists, such as a physician
- obtained from an NIHB-recognized provider who is eligible to deliver the specific medical supplies or equipment
The NIHB MS&E Guide and Benefit Lists contains more information on:
- requirements for:
- providers
- prescribers
- how to access the benefits
Medical supplies and equipment benefits include:
- audiology
- communication
- footwear
- limb and body orthotics
- low vision
- medical surgical
- mobility
- oxygen
- pressure devices
- prosthetics
- respiratory
- self-care
Medical supplies and equipment benefits are covered in accordance with program policies. Benefit coverage details are provided in the NIHB MS&E Guide and Benefit Lists. Exceptions are items which are not currently listed in the NIHB MS&E Guide and Benefit Lists. Coverage may be provided on a case-by-case basis for these items.
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 medical supplies and equipment benefits
Eligible clients can access medical supplies and equipment benefits from an NIHB-recognized provider.
A valid prescription from an NIHB-recognized prescriber is required for any MS&E claim. While many items are covered directly (no prior approval needed), certain requests must be reviewed by the corresponding NIHB regional office before a coverage decision can be made. Prior approval and assessment forms can be found on the MS&E forms webpage, found on the Express Scripts Canada NIHB Provider and Client Website.
NIHB-recognized providers are asked to send claims for payment directly to the program, so that clients do not have to pay upfront and out-of-pocket on their medical supply or equipment claims. Clients will need to show client identification in order for providers to bill the program directly.
Express Scripts Canada processes claims and payment for providers and clients on behalf of the program. The Express Scripts Canada NIHB Provider and Client Website contains information on:
How to access NIHB forms for health professionals
Health professionals can access MS&E forms, available on the Express Scripts Canada NIHB Provider and Client Website (for example, assessment forms, prior approval forms, recommendation forms, etc.)