Non-Insured Health Benefits (NIHB)

Andrew Ross
Coordinator
Phone: 204-676-2218 ext 235    Cell: 204-679-7420

Objectives

Is to ensure NIHB recieve the necessary and appropriate means of medical treatments, travel and accomodations.

The program provides

Client Eligibilty

• A registered Indain according to Indian Act
• An infant up to one year old of an eligible parent
• Currently regidtered or eligible for regidtration, under Manitoba Health

General

• NIHB Medical Transportaion Program is provided to assist clients to access medically required health services that cannot be obtained on the reserve of residence
• Financial assistance may include coverage for some or all of the travel expenses incurred by clients
• The most efficient and economical medical transportation benefits are to be used at all times

Transportation benefits may be provided for access to

• Appointment with physician and specialist
• Diagnostic tests, medical treatment
• Hospital and emergency room admission
• Day surgery
• Alcohol, solvent, drug abuse, detoxification
• Traditional healers
• Other NIHB Benefits (vision, dental)

Criteria

• That the medically required health services are not available on the reserve of residence
• Must be prior approved (except emergency)
• When more than 1 medically required service is required in a week, where pratical and economical, appointments and travel arrangements will be scheduled for the same day to ensure optimum cost-effectiveness

Repeated/Long term travel

Medical transportaion benefits will only be provided for a maximum of up to 4 months if it is determined by a physician that the continual transportation of the client is not in the best interest of the client or

The ongoing travel costs are not the most effieicent and economic method of transportaion

Private Vehicle

• Approved only when determined that a private vehicle is the most appropriate, efficient and economical means of transportation
• Reimbursement for use of a private vehicle is issued to the client and/or parent/guardian
• When public transportation is available and the client chooses to use his/her own private vehicle, reimbursement will be made at either equivalent public transportation rate or at the established private vehicle kilometer allowance rate, whichever method is the lesser

Assistance with meals may be provided where the time away from home to attend the medically required appointment os more than 6 hours in one day. This would be payable at a rate of up tto $10.00. Breakfast if not payable for same day trips. The following is a table created for your breakdown of eiligable meal expenditures, depending on clients mode of transportation

Reimbursable rate: all trips are return

Escort Criteria

• A Family member who is required to sign consent forms or provide a patient history
• A reliable member of the community
• Physically capable of taking care of themselves and the client not requiring assistance or an escort themselves
• Proficient in translating
• Able to share personal space to support the client
• Interested in the well being to the client
• Unless there is a requirment for an escort to stay longer or it is more economical, the escort shall return to the community by the earliest reasonable means

Accomodations

• When a trip includes an overnight or extended stay away from the Client's residence, the most efficient and economical type of accommodation will be chosen, taking into consideration: client's health condition, location of accommodation and travel requirements to access required health services
• Clients who choose to make alternate arrangements will be reimbursed at the private accommodation rate of $25.00 per person, per night including meals

Appointments

Appointments must be confirmed by the Return Clerk before forwarding to FNIH for prior approval.
If a client does not attend a scheduled appointment, the Client may have to assume the cost of the return trip or of the next trip unless justification is provided to explain why the Client was unable to attend.
Traditional Healers:

• Assistance with transportation omly; provided within the Client's home region (i.e. manitobe)
• Must be prior approved ny NIHB
• Criteria
  Traditional Healer is recognized by the Band, Tribal Council or health professional

A licensed physician, or if a licensed physician is not routinely available in the community, a community health professioanl has confirmed that the client has a medical condition.
Costs for honoraria, ceremonial expenses or medicines are not reimbursed.

NNADAP

• Client is assessed by the community NNADAP worker
• Client is referred to the nearest appropriate facility
• Return transportation is provided only when the Client completes treatment
• Out of province NNADA requests a approved by FNIH regional Office only

Appeals:

Must be in writing by the Client, legal guardian or interpreter
3 levels of appeals are available:

• Level 1 - is the NIHB Director, Pam Smith
• Level 2 - is the FNIH Regional Director, Jim Wlfe
• Level 3 - is the Director General, FNIH, Ottawa, ON, Ian Potter