Insurance and Non-Insured Health Benefit Program or NIHB for First Nations and Inuit
The Non-Insured Health Benefit program or NIHB for First Nations and Inuit patients does cover orthodontic treatment, but only in quite limited cases.
Hi. I’m Dr Campbell with another smilesooner video for braces and your smile.
The NIHB program for First Nations patients has reduced the number of people covered over the past years. Like any program or just like any of us really, we’d like to do this…
But only have the money to cover this..
The program only covers situations where there is a severe and what they call a functionally limiting malocclusion. This means that not only do you have to have really crooked teeth, but this has to produce a significant problem with chewing and speaking.
The program only covers people up to the age of eighteen. Your treatment can go past that, but you have to apply for treatment before the age of eighteen.
The program’s guidelines specifically exclude the appearance of your teeth, cases where self-esteem is affected by your teeth, and problems with the jaw joint. So these things aren’t covered by the program.
This program is administered by the Government. As orthodontists in practice and treating people, we have no say in whether a person is covered. The people who do make these decisions are doing the best they can with the limited funding that every program has.
We’re happy to see you and talk about your orthodontic situation. We can let you know if NIHB coverage s a possibility and collect the orthodontic study records that need to go in to the program for them to consider covering your treatment.
Now the rules in Manitoba and Ontario are slightly different. For people in Ontario, for us to see you to apply for NIHB funding, your dentist has to start the paperwork with them and then we can see you for that first visit and take it from there.
For people in Manitoba, you must be seeing your dentist regularly and be cavity free for six months with good oral hygiene. So if you have a cavity, you’ll have to wait six months until we can see you for that first appointment to get things started.
But if your dentist wanted me to give an opinion or more information on what’s going on before that, we could certainly do that. We just couldn’t do anything else if you want coverage under the NIHB program.
And oral hygiene is a big issue. Keeping your teeth clean with braces isn’t hard, but it’s super important for your health and the success of your braces to give you a great smile. The NIHB program will want to see really clean teeth. And we’ll be sending in photographs into the program so they’ll know how well you’re brushing. If they see dirty teeth with puffy, red or bleeding gums, there is no doubt that they will not cover orthodontic treatment.
You don’t want this to get in the way of NIHB funding of your braces, if your teeth are really crooked.