NIHB Handbook (PDF) - First Nations Health Directors Association
NIHB Handbook (PDF) - First Nations Health Directors Association
NIHB Handbook (PDF) - First Nations Health Directors Association
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2. DENTAL BENEFITS<br />
What is covered?<br />
Dental services covered under the <strong>NIHB</strong> Program are divided into two (2) schedules:<br />
■■<br />
■■<br />
Schedule A lists services that may be provided without predetermination* within <strong>NIHB</strong><br />
Program limits;<br />
Schedule B lists services that require predetermination.<br />
*Predetermination is defined on page 12.<br />
Payment for treatment is made to the provider/client/third party for the services listed<br />
below. Certain dental benefits, as specified below, require predetermination from the <strong>Health</strong><br />
Canada regional office or the Orthodontic Review Centre (ORC).<br />
Diagnostic<br />
services<br />
(exams and X-rays)<br />
Exams:<br />
• y Under the age of 17: eligible for up to four (4) examinations in any<br />
12-month period.<br />
• y 17 years +: eligible for up to three (3) examinations in any 12-month<br />
period.<br />
X-rays:<br />
• y Eligible for six (6) single x-rays in any 12-month period.<br />
y • Eligible for one (1) panoramic (rectangular shot) x-ray in any<br />
120-month period (10 years) without predetermination; up to 2 per<br />
lifetime.<br />
8<br />
Your <strong>Health</strong> Benefits n A GUIDE FOR FIRST NATIONS TO ACCESS NON-INSURED HEALTH BENEFITS
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