Non-Insured Health Benefits program for First Nations and Inuit: Pharmacy benefits
Learn about pharmacy benefits available to eligible clients under the Non-Insured Health Benefits (NIHB) program.
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About pharmacy benefits
The NIHB program covers prescription drugs and select over-the-counter products that are:
- included on the Drug Benefit List, which encompasses:
- open benefits, which do not require prior approval, but may have conditions regarding age, quantity, frequency or dose
- limited use benefits, which may be eligible for coverage if the criteria for coverage are met
- prescribed or recommended by a licensed health professional, within their scope of practice
Exception products are not listed in the Drug Benefit List but may be approved in special circumstances.
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.
Drug Benefit List
The Drug Benefit List is a listing of the drugs and other health products provided as benefits by the NIHB program. The listed drugs are those primarily used in a home or ambulatory setting.
The Drug Benefit List is available on the Express Scripts Canada NIHB Provider and Client Website. Express Scripts Canada provides claims processing and related services under contract to Indigenous Services Canada.
A downloadable and print ready version of the Drug Benefit List is available on the Drug Benefit List webpage, on the Express Scripts Canada NIHB Provider and Client Website (select "Download Drug Benefit List" and click on the link of the PDF version of the list).
How to access pharmacy benefits
Clients can access pharmacy benefits from a licensed pharmacy.
A prescription from a licensed prescriber is required for any listed prescription drugs to be processed as a benefit. Prescribers are those people authorized to prescribe drugs within the scope of practice in their province or territory. NIHB also accepts client-specific written recommendations for listed over-the-counter products from licensed health professionals, when it falls within their scope of practice.
Providers who are enrolled with the NIHB program generally send in claims to bill the NIHB program directly. This means clients do not have to pay a deductible or co-payment. Clients will need to show client identification in order for providers to bill the NIHB program directly.
Express Scripts Canada administers claims on behalf of the NIHB program.