COVID-19 NON-INSURED HEALTH BENEFITS POLICY UPDATES

Posted by: Ira Timothy
in: All News

EXPIRED STATUS CARDS

Access to NIHB will still be granted even with an expired Indian Status card during the COVID-19 pandemic. The individual’s registration number can be used to process the benefit regardless of date of expiry.

PHARMACY

The NIHB Program has temporarily lifted the prior approval requirement for many limited use medications. Pharmacists have been advised of this change and asked to submit all NIHB client prescriptions electronically to see if the medication is covered as open benefit (meaning you do not need prior approval from NIHB for its full cost to be covered).

For pharmacy, the NIHB Program is temporarily suspending the full applicability of the 28-day short term dispense policy. “If a medication falls under the 28-day short term dispensing policy, providers may submit claims for between seven to 27 days using the Special Service Code (SSC) “2” to receive a full dispensing fee. NIHB’s 7-day short term dispense policy will continue to be in effect.”

The NIHB Drug Exception Centre (DEC) continues to process requests for prior approval and can be reached at 1-800-580-0950.

MEDICAL SUPPLIES & EQUIPMENT

NIHB has a temporary policy for those requiring certain medical equipment but are unable to see their prescriber. The MS&E provider may use the existing prescription on file for the replacement of:

• limb and body orthotics
• custom made shoes and orthotics
• medical grade compression stocking
• mobility equipment
• incontinence and ostomy supplies
• self-care benefits (e.g. lift, transfer equipment, urinal)

An interim policy for accessing respiratory equipment has also been put into place. Testing requirements for respiratory equipment are adjusted to enabling provider assessment forms to be completed over the phone during the pandemic. Policy adjustments for CPAP and BPAP and communication equipment have also been made.

NIHB clients are encouraged to consult with their health or benefit service provider to confirm whether routine, non-urgent appointments should be postponed or if they have been cancelled.

NIHB will continue to support to clients who need medical transportation benefits to access urgent or essential medical services. Vulnerable clients will be supported by prioritizing private modes of transport.

ADDITIONAL RESOURCES & CONTACT
If you have any questions, issues, or concerns related to NIHB contact a Chiefs of Ontario NIHB Navigator (Emily.king@coo.org or Miryan.rutledge@coo.org) or use the Ontario Region Client
Information Line: 1-800-640-0642


Any questions or concerns can also be forwarded to the AIAI Health Policy Advisor at Tpowell@aiai.on.ca or 519-282-5740

More information on respiratory equipment: https://provider.express-scripts.ca/medicalsupplies-and-equipment/bulletins

More information on pharmacy: https://provider.express-scripts.ca/pharmacy/bulletins

Email for claim submissions and enquiries: Nihbontarioinvoices@hc-sc.gc.ca

NIHB Drug Exception Centre: 1-800-580-0950 ext. #3

Dental and Orthodontic Services NIHB Dental Predetermination Centre:
1-855-618-6291 (Dental Services) 1-866-227-0943 (Orthodontic Services)

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