Medical supplies and equipment benefits for First Nations and Inuit
Learn about the benefits for medical supplies and equipment (MS&E) 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 Medical Supplies and Equipment Guide and Benefit Lists. These items must be:
- prescribed by an NIHB-recognized health professional listed in the Medical Supplies and Equipment benefit lists, such as a physician
- obtained from an NIHB-recognized provider who is eligible to deliver the specific medical supplies or equipment
The Medical Supplies and Equipment Guide and Benefit Lists contains more information on:
- requirements for:
- how to access the benefits
Medical supplies and equipment benefits include:
- limb and body orthotics
- low vision
- medical surgical
- pressure devices
Medical supplies and equipment benefits are covered in accordance with program policies. Benefit coverage details are provided in the Medical Supplies and Equipment Guide and Benefit Lists. Exceptions are items which are not listed in the NIHB medical supplies and equipment benefit list and are not listed as exclusions. These may be considered on a case-by-case basis.
The program provides eligible clients with coverage of benefits not available under other federal, provincial, territorial or private health insurance.
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 at Express Scripts Canada.
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. You 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 forms for health professionals
Health professionals can access medical supplies and equipment forms available on the Express Scripts Canada NIHB provider and client website (for example, assessment forms, prior approval forms, recommendation forms, etc.)
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