NIHB Handbook (PDF) - First Nations Health Directors Association

5. Treatment plan, estimated duration of active and retention phases of treatment and costs
submitted either on a NIHB Orthodontic Summary Sheet, CAO Standard Orthodontic
Information Form or letter on the Orthodontist’s letterhead;
6. Completed NIHB Dental Claim Form; and
7. Parent or legal guardian signature (including Band name and number and/or date
of birth).
To initiate an appeal, the client, the parent, legal guardian, or representative must submit
their documentation addressed to:
Level 1
Orthodontic Review Centre
Director, Benefit Review Services Division,
First Nations and Inuit Health Branch – Health Canada
Non-Insured Health Benefits Directorate
Postal Locator 1902C
200 Eglantine Driveway, 2 nd Floor, Tunney’s Pasture
Ottawa, Ontario K1A 0K9
Level 2
Orthodontic Review Centre
Director, Benefit Management Division,
First Nations and Inuit Health Branch – Health Canada
Non-Insured Health Benefits Directorate
Postal Locator 1902C
200 Eglantine Driveway, 2 nd Floor, Tunney’s Pasture
Ottawa, Ontario K1A 0K9
Level 3:
Orthodontic Review Centre
NIHB Director General,
First Nations and Inuit Health Branch – Health Canada
Non-Insured Health Benefits Directorate
Postal Locator 1902C
200 Eglantine Driveway, 2 nd Floor, Tunney’s Pasture
Ottawa, Ontario K1A 0K9
For more information, visit: http://www.hc-sc.gc.ca/fniah-spnia/nihb-ssna/benefitprestation/appe/index-eng.php
or contact the Orthodontic Review Centre.
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Your Health Benefits n A GUIDE FOR FIRST NATIONS TO ACCESS NON-INSURED HEALTH BENEFITS