Purpose
The purpose of these benefits is to assist clients to obtain medical supplies, and medical equipment through a medical prescription.
Medical supplies are products for personal use, and are listed separately.
Medical equipment are items not consumed or depleted by the individual on a regular basis and are listed separately.
Product limitations:
- Multivitamins are a benefit for infants only, and up to 2 years of age.
- Single entity vitamins in therapeutic strength for specific pathology may be provided as deemed necessary by NVHA medical professionals.
- Prenatal vitamins are a benefit for females aged 12 to 50 years.
- Accutane requires prior approval for females between 12 to 50 no prior approval for other NIHB clients.
What is covered?
- Audiologist (hearing aids)
- Medical equipment (wheelchair, walker)Medical supplies (ostomy, bandage, dressing)
- Orthotics and custom footwear
- Pressure garments, prosthetics, oxygen therapy, Respiratory therapy
Criteria Used by NVHA’s NIHB Program
- The item is on the NIHB MS&E list. Items not on the MS&E list are products, fixtures, or equipment permanently installed in the home (ramps, bars screwed to the wall, etc.).
- The item is intended for use in a home setting or other ambulatory care settings.
- Prior approval when required is granted by the NVHA-NIHB Program Team Lead/Designate.
- The item is not available to the client through any other federal, provincial, territorial or third party health care program.
- The item is prescribed by a physician or medical specialist as indicated in each of the benefit areas.
- The item is provided by a recognized provider as indicated in each of the benefit categories.
- NVHA MS&E/Vision Assessor has access to the MS&E Benefit list.
The same criteria will apply to all items listed under “What is Covered”.
How to Access MS&E Program Benefits
Step 1: All MS&E items require prior approval. Please bring your prescription to an appropriate provider and they will contact our MS&E/Vision Assessor for the appropriate form(s) to be completed with required medical information from your prescribing specialist.
Step 2: Request will be reviewed, and if prior approval is granted, a PA number will be provided for billing purposes.
Step 3: Only then should a provider proceed with the fabrication, fitting or dispensing of the item. In the case where a prior approval is not granted, the provider and client will be advised with the reason(s).
What are your responsibilities?
- Non-Insured Health Benefits is the payer of last resort, so please claim under any other health plan before accessing Nisga’a NIHB.
- Tell the provider that you are eligible to receive benefits under the Nisga’a NIHB Program and provide your Great West Life benefits number, and your Nisga’a Citizenship number.