The Non-Insured Health Benefits (NIHB) program provides eligible First Nations and Inuit clients with coverage for a range of health benefits, including ostomy supplies, that are not covered through other:
To be eligible for benefits under Health Canada’s Non-Insured Health Benefits (NIHB) Program, you must be a Canadian resident and be:
NIHB provides 100% coverage to eligible clients for ostomy supplies. Medical travel expenses are also covered. To access benefit coverage, show your health care provider your client identification to confirm your eligibility with the program. Coverage is available only for ostomy supplies obtained in Canada.
NIHB covers a comprehensive list of ostomy supplies:
For a complete list of ostomy products covered by NIHB, please visit this website: https://www.sac-isc.gc.ca/eng/1590168766044/1590168799917#s13-3
NIHB covers a particular quantity of ostomy supplies, and orders should be placed every three months. For instance, you are limited to 30 drainable ostomy bags every three months. A health care professional can provide a letter of exemption and prescription if you require extra ostomy supplies for medical reasons. Exceptions are items that are not listed in the NIHB medical supplies and equipment benefit list. These may be considered on a case-by-case basis. For example, products that are not covered, like high output ostomy bags, or a larger quantity of a product is needed than covered may be approved for an exception.
Ostomy vendors are encouraged to bill the NIHB Program directly so that you do not have to pay for services when receiving health care goods or services; however, you may be required to pay up front and be reimbursed later.If you have paid directly for goods or services, you may seek reimbursement from the NIHB Program within one year from the date of service and/or date of purchase. To be reimbursed, the service or item must be listed with the NIHB Program. All requests for reimbursement of eligible NIHB benefits must include the original receipts; and a copy of the prescription. Ostomy supply claims are processed through Express Scripts. Please visit their website to create an account and submit your claims online.