Health Advocacy includes:

Services and benefits, insured and uninsured, provided on and off-reserve to First Nations people; services for children and their families as expressed in Jordan’s principle; navigation through the health system; home and palliative care.

Overview

The NIHB Program is a national program which is designed to support First Nations people in reaching an overall health status that is comparable with Canadians. The NIHB Program is also designed to help individuals maintain their health, prevent disease, assist in detecting and managing illnesses, injuries, and disabilities.

The NIHB Program is to provide applicable coverage for a limited range of medically necessary goods and services to registered First Nations members. It may cover the costs of some, or all, medical, dental, and pharmacy services that eligible First Nations members may need.

The NIHB program may provide medically necessary goods and services when they are not covered by provincial or other third-party health plans. Third party health plans are ones usually provided by private insurance companies through a paid premium by the purchasing individual. The benefits and services of the NIHB Program are often coordinated with other insured health care programs offered in Ontario.

The Non-Insured Health Benefits Program provides benefit coverage for approximately 176,400 First Nations people in Ontario.  These benefits include: Drugs, Dental, Medical Supplies & Equipment, Medical Transportation, Eye & Vision Care, Short-term Crisis Intervention Mental Health Counselling, and Health Benefits Outside of Canada.

Important Client Information

To ensure you are eligible for a benefit and do not end up with out-of-pocket expenses for a service that was provided to you by one of the NIHB service providers, please ask the service provider if:

1. They bill directly to the NIHB Program and/or
2. If the service is an eligible benefit within the NIHB Program

If you still have further concerns and/or questions in regards to your eligibility for a medical item, supply, service, and/or travel provided under the Non-Insured Health Benefits program, please call:

• Your local community health representative who works with the Program; and/or
• NIHB Client Information Line at 1-800-640-0642; this number is for inquiries on all benefit areas except Dental benefits.

Expresscripts Client Line: 1-888-441-4777

The NIHB Dental Predetermination Centre for dental and orthodontics is:

Dental Services: Toll Free 1-855-618-6291

Orthodontic Services: Toll Free 1-866-227-0943

NIHB Navigators: Overview

The NIHB Navigator positions were part of the dialogue during the First Nation Contribution to the Blueprint on Aboriginal Health, and resolution 52/2005 of the Assembly of First Nations (AFN). During this time, the AFN documented more than 300 calls for assistance from individual clients over a 2 year period, and noted an increase in the challenges faced by First Nations when accessing NIHB Program benefits. This was due to the NIHB program being subjected to several policy and cost management initiatives since the late 1990s. There are now navigators in almost every region and territory across the county.

In 2010 the Chiefs of Ontario were successful in negotiating with FNIH/Ontario Region for two Non-Insured Health Benefits Navigators. The Navigators provide advocacy and liaison support on behalf of First Nation communities, community health workers and their clients, and organizations as it relates to the NIHB Program. The navigators also assist in addressing and resolving NIHB issues on behalf of First Nation communities and organizations to make NIHB more accessible and less challenging for Ontario First Nations.