Question Period Note: Non-Insured Health Benefits program for First Nations and Inuit

N.A.

• The Non-Insured Health Benefits (NIHB) program provides clients (registered First Nations and recognized Inuit) with coverage for a specified range of health benefits.
• The program covers prescription and over-the-counter medications, dental and vision care, medical supplies and equipment, mental health counselling, and transportation to access health services not available locally, where these services are not otherwise covered by other plans or programs for which the client is eligible.

Program Eligibility
To be eligible for NIHB Program benefits, an individual must be a resident of Canada, and registered or eligible to be registered under a provincial/territorial health insurance plan and have the following status:
• a First Nations person who is registered under the Indian Act (living on or off-reserve);
• an Inuk recognized by an Inuit Land Claim organization (i.e. Nunavut Tunngavik Incorporated, Inuvialuit Regional Corporation or Makivik Corporation);
• or a child, less than 2 years old, whose parent is an eligible NIHB Program client
NIHB Program Benefits
Pharmacy and Medical Supplies and Equipment
• The NIHB Program covers a range of prescription drugs and select over-the-counter products listed on the NIHB Drug Benefit List.
• A specified range of medical supplies and equipment (MS&E) items are also covered by the Program.
Dental
• Dental services must be provided by a licensed dental professional, such as a dentist, dental specialist, independent dental hygienist or denturist.
• Services include diagnostic (i.e. exams and x-rays), preventive (i.e. cleanings), restorative (i.e. fillings), endodontic (i.e. root canals), periodontal (i.e. deep scaling), removable prosthodontic (i.e. dentures), oral surgery (i.e. extractions), orthodontic (i.e. braces) and adjunctive services (i.e. sedation).
Medical Transportation
• NIHB Medical Transportation benefits coverage is provided to assist eligible clients to access medically necessary health services that cannot be obtained in their community of residence.
•Benefits include:
o Ground Travel (private vehicle; commercial taxi; fee-for-service driver and vehicle; band vehicle; bus; train; snowmobile taxi; and ground ambulance);
o Air Travel (scheduled flights; chartered flights; helicopter; and air ambulance);
o Water Travel (motorized boat; boat taxi; and ferry);
o Living Expenses (meals and accommodations); and
o Transportation costs for health professionals to travel into communities to provide services, where this is a more cost effective approach.
Vision Care
• NIHB funds a range of vision care benefits including:
o General eye examinations, when they are not insured by the province/territory;
o Corrective eyewear such as glasses or contact lenses, when prescribed by a licensed vision care professional;
o Corrective eyewear repairs and replacement ; and
o Other vision care benefits such as single eye tests depending on the specific medical needs of the client.
Mental Health Counselling
• The mental health counselling benefit is intended to provide coverage for professional mental health counselling to complement other mental wellness services that may be available‎.
• Clients receive coverage for 22 hours of counselling per year, with additional coverage available in exceptional situations.
Sioux Lookout First Nation’s Health Authority (SLFNHA)
• SLFNHA has raised concerns related to NIHB operations, including transportation, hostel services, funding, and service access.
• NIHB provides coverage for medical transportation, including travel, accommodations, meals, and escorts when required.
• Clients traveling to Thunder Bay are currently hosted at Wequedong Lodge, with alternate accommodations used when needed.
• Transportation services must be pre-approved; SLFNHA’s van operations in Thunder Bay had no prior agreement and are not reimbursable.
• ISC funding supports SLFNHA health service delivery and ongoing discussions continue regarding service needs and delivery
• A rally in Sioux Lookout in early June 2026 brought together First Nations leaders and health partners to protest NIHB-related concerns and access to care.

If pressed on Non-Insured Health Benefits
• The NIHB Program does not directly deliver health services to its clients, rather benefits are delivered through service arrangements with private practice health care professionals/providers, and contribution agreement recipients such as First Nation and Inuit partners.
• During 2024-2025, the NIHB Program provided access to benefits coverage for 983,461 eligible clients. Total Program benefit expenditures in this period were $2,330.7 million; a 11.1% increase over 2023-2024.
• The NIHB Program provides coverage to eligible clients of all ages, in Canada unless otherwise covered under a separate agreement (such as a self-government agreement). Sioux Lookout First Nations Health Authority - Thunder Bay Medical Transportation Program (SLFNHA)
• Indigenous Services Canada (ISC) values SLFNHA as a key partner serving 33 First Nation communities.
• SLFNHA suspended its Thunder Bay medical transportation program effective April 1, 2026, citing lack of funding.
• Funding decisions are based on demonstrated need, utilization, and financial reporting.
• While additional funding requested for this program was not supported, ISC provided nearly $1.4M in 2024–25.
• ISC continues to review program data and will work with SLFNHA to ensure funding aligns with demonstrated needs and program requirements.
• Any future funding decisions will be based on updated reporting, utilization trends, and demonstrated demand for eligible NIHB services. If pressed on missed medical appointments
• ISC recognizes the importance of ensuring clients can attend medical appointments without disruption.
• In March 2026, approximately 81.5% of requested medical transportation trips in Ontario were successfully booked.
• Unbooked or missed travel may occur due to short notice requests, incomplete information, client availability, or external factors such as flight and accommodation capacity.
• ISC continues to work with SLFNHA to improve coordination and timeliness of medical transportation services. If pressed on funding decisions
• NIHB medical transportation funding supports eligible travel to access medically necessary services.
• Requests for increases are assessed against program criteria, utilization data, and reporting.
• Current analysis indicates existing funding levels are appropriate.
• Long-term funding remains stable, with over $874K annually committed beginning 2026–27.
• ISC continues to work with partners to ensure efficient and equitable use of resources. If pressed on service impacts
• ISC continues to reimburse eligible NIHB transportation costs for clients.
• Alternative transportation options, including in-city service providers, remain available in Thunder Bay.
• ISC is working with SLFNHA to support continuity of access to care.
• Patients will continue to receive coverage for medically necessary transportation under NIHB policies.