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The Non-Insured Health Benefits (NIHB) Program
provides supplementary health benefits, including dental treatment,
for registered First Nations and recognized Inuit throughout Canada.
Visit our Web Site at:
The purpose of this bulletin is to:
NIHB is a publicly funded Program that covers a limited range of orthodontic benefits for eligible First Nations and Inuit. Clients must meet the clinical criteria and guidelines established by the NIHB Program for their orthodontic treatment to be funded.
A severe and functionally handicapping malocclusion is characterized as:
Note: The complete list of NIHB Guidelines for Comprehensive Orthodontic Treatment can be found in the Dental Practitioners Information Kit (DPIK) and in the NIHB Orthodontic Bulletin dated June 2002. Both documents can be found on the NIHB Web site.
The NIHB Program can only determine if a client meets the Program's funding criteria by reviewing the client's records and treatment plan. Health Canada relies on orthodontists to help individuals submit the required information. Unfortunately, the Program cannot provide orthodontic treatment funding if this information is not submitted for review.
Orthodontic treatment funding requests submitted to the Orthodontic Review Centre (ORC) must include:
1. A Narrative
The above information can be submitted on either a NIHB Orthodontic Summary Sheet; CAO Standard Information Form; or on the Orthodontist's letterhead.
2. Complete Diagnostic Records
3. A Completed NIHB Dent-29 Form
for more information refer to Dental Practitioners Information Kit (DPIK)
As a prevention initiative, funding will be considered for the provision of interceptive orthodontic treatment (80000 series procedures) in the mixed dentition phase of dental development.
As per the May 2000 National Agreement between the Canadian Association of Orthodontists (CAO), Health Canada and the Assembly of First Nations, payment codes or the specific wording indicated below must be used when submitting a claim.
Payment Structure for Comprehensive Orthodontic Treatment:
This one page form will satisfy the need for a National Standard for final payment and reduce administration requirements. It can be submitted by the provider upon completion of orthodontic treatment and attached to the Dent-29 Form indicating "post approval". With this form, pre/post orthodontic treatment records are not required to be submitted to obtain final payment (P1400). A copy of this form is enclosed. Additional forms can be obtained by contacting the ORC.
Health Canada prefers that providers bill the NIHB Program directly for services so there are no upfront charges to clients. However, dental providers have the choice to request the patient pay and seek reimbursement from the Program.
Please remember to forward all orthodontic treatment requests directly to the Orthodontic Review Centre and not to the NIHB Regional Offices. Sending requests to the wrong office will result in significant processing delays.
Orthodontic Review Centre
Non-Insured Health Benefits
First Nations and Inuit Health Branch
55 Metcalfe Street, 5th Floor
Postal Locator 4005A
Toll-Free Phone: 1-866-227-0943
Toll-Free Fax: 1-866-227-0957