NIHB: Drug Coverage for Indigenous Peoples in Canada

What Is the Non-Insured Health Benefits (NIHB) Program?

The Non-Insured Health Benefits (NIHB) program is a federal program administered by Indigenous Services Canada. It provides coverage for a range of health benefits — including prescription drugs — to eligible First Nations and Inuit people who are not covered by other plans.

NIHB is not insurance in the traditional sense. It is a federal benefit funded by the Government of Canada and designed to supplement provincial and territorial health programs.

Who Is Eligible?

You may qualify for NIHB drug coverage if you are:

A registered First Nations person (Status Indian) under the Indian Act
A recognized Inuit person enrolled under an Inuit land claim

Important Notes on Eligibility

You do not need to live on-reserve to qualify
Metis individuals are generally not eligible for NIHB (though some provinces have separate programs)
If you have private insurance through an employer, NIHB acts as a secondary payer — it covers what your private plan does not

What Drugs Does NIHB Cover?

NIHB maintains its own drug benefit list that includes thousands of prescription medications. Coverage includes:

Prescription drugs on the NIHB formulary
Some over-the-counter medications when prescribed by a doctor
Diabetes supplies including insulin, test strips, and syringes
Medical supplies related to chronic conditions

How the Formulary Works

Drugs on the NIHB list fall into three categories:

Category	Description	Approval Needed?
Open Benefit	Covered automatically	No
Limited Use	Covered for specific conditions	Sometimes (may need a code)
Prior Approval	Requires authorization	Yes — doctor must submit a request

If your medication requires prior approval, your doctor or pharmacist can submit the request to NIHB. Approval can take 5 to 15 business days, so plan ahead when possible.

How to Use NIHB at the Pharmacy

Using NIHB coverage at the pharmacy is straightforward:

Present your Status Card or NIHB client ID number

The pharmacist submits the claim electronically to NIHB

If the drug is covered, you pay nothing at the counter

If a co-pay or balance applies (rare), the pharmacist will let you know

Pro tip: Not all pharmacies are experienced with NIHB billing. If you encounter issues, ask the pharmacist to contact the NIHB drug exception centre at 1-800-580-0950.

Common Challenges and How to Handle Them

Drug Not on the Formulary

If your medication is not listed, your doctor can submit a prior approval request or a drug exception request. These are evaluated case by case, and coverage is often granted for medically necessary treatments.

Coordination With Private Insurance

If you have both NIHB and employer drug coverage, your private plan pays first. Submit the remaining balance to NIHB. This coordination of benefits ensures you pay as little as possible out of pocket.

Moving Between Provinces

NIHB is a federal program, so your coverage follows you across provincial borders. However, the pharmacies you visit must be enrolled as NIHB providers.

Additional NIHB Health Benefits

Beyond prescription drugs, NIHB also covers:

Dental care
Vision care (eyeglasses and exams)
Medical transportation to access health services
Mental health counselling
Medical supplies and equipment

Getting Help

NIHB Information Line: 1-800-580-0950
Online: www.sac-isc.gc.ca — search for NIHB
Jordan's Principle — for First Nations children, additional health supports may be available

If you are comparing drug prices or checking whether a pharmacy near you accepts NIHB, TransparentMedz can help you locate pharmacies and compare costs so you know your options before you arrive.

Know Your Benefits

NIHB is a valuable program that many eligible individuals underuse. If you are a registered First Nations person or recognized Inuit, make sure you understand what is covered and advocate for your health needs.