Article supplied by Indigenous Services Canada
The Non-Insured Health Benefits (NIHB) Program provides clients (registered First Nations and recognized Inuit) with coverage for dental services, including diagnostic (i.e. exams and X-rays), preventive (i.e. sealants), restorative (i.e. fillings), endodontic (i.e. root canals), periodontal (i.e. scaling), removable prosthodontic (i.e. partial and complete dentures), oral surgery (i.e. extractions), orthodontic (i.e. braces), and adjunctive (i.e. sedation, general anesthesia) services.
The NIHB Program has evolved over the years!
Reduced predetermination (PD) requirements and extended coverage
- Removed the predetermination requirement for coverage of standard root canal treatments (except wisdom teeth), mild sedation, surgical tooth extractions, prefabricated posts, standard complete dentures
- Added coverage for topical antimicrobial and remineralization treatments such as silver diamine fluoride
- Enhanced coverage for sealants/preventive resin restorations to include bicuspids and increase the age limitation to up to 18 years
- Expanded coverage for all-porcelain/ceramic crowns and for crowns on second molars
- Increased service frequency for acrylic partial dentures, from one (1) in eight (8) to 1 (one) in 5 (five) years per arch
As an NIHB enrolled dental provider, you gain access to online self-serve functions!
Express Scripts Canada (ESC) manages the NIHB Provider and Client Website (nihb-ssna.express-scripts.ca/en), where providers have the option of creating a web account to access services in order to:
- Submit online predetermination (PD) requests (new!)
- Check the status of PD requests
- Verify client eligibility and next available date
- Submit claims for processing
- Submit enrolment documents
- Update contact information
- Access claim statements
- View claims history
- Request update to direct deposit information
- Once approved, view your NIHB provider number
To create a secure web account through the Express Scripts Canada, visit:
https://nihb-ssna.express-scripts.ca/en/provider > online enrolment > new NIHB provider > create account
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Play a key role in contributing to improving the oral health of First Nations and Inuit |
| By enrolling to the NIHB Program and submitting claims directly to Express Scripts Canada using the NIHB fees, clients do not have to face charges at the point of service, which can be a significant barrier to access dental care. |
For any questions related to an NIHB web account or self-service options, enrolment, client and dental service eligibility, or billing process (including payment), please contact:
NIHB Call Centre at Express Scripts Canada: 1 888 511-4666
For more information about the NIHB Program and its dental policies, or the status/outcome of specific PD request, please contact:
NIHB Dental Predetermination Centre
Dental services: 1 855 618-6291
Orthodontic services: 1 866 227-0943
