Submit the completed and signed form along with all receipts and supporting documents to 1 888 249 6098.
Medical supplies and equipment claim form nihb.
Many health service providers are once again scheduling routine and non emergency appointments as part of bc s restart pl an health benefits coverage continues to be available so that you can access the medical supplies and equipment you need.
Exceptions are medical supplies and equipment that are not currently listed on the nihb medical supplies and equipment benefit lists.
Documents required by the nihb program to reimburse costs related to health services can be found on the next page of this form.
This form may be used to recommend medical supplies and equipment eligible for coverage under the non insured health benefits program.
Prior approval must be sought with written medical justification from the nihb regional office.
Medical supplies and equipment.
To submit a client reimbursement request by mail.
Not what you are looking for.
Medical supplies and equipment claim form.
Programme des services de santé non assurés ssna.
Your authorization in order to collect information from your provider for services provided to you and paid for by the non insured health benefits.
Non insured health benefits nihb for eligible first nations and inuit.
Go back to the express scripts canada website.
Pour équipement médical et fournitures médicales.
Benefits covered can be found on the nihb ms e benefit lists.
Complete the nihb client reimbursement form online or print it out.
The recommender must do a complete assessment prior to completing this form.
Non insured health benefits nihb program hc nihb august 2011 nihb client reimbursement request form.
Nihb general medical supplies and equipment prior approval form.
This is not an assessment form.
Complete the nihb client reimbursement form online or print it out.
For additional information including.
Medical supplies and equipment service update.
Formulaire de demande de paiement.
Coverage may be provided on a case by case basis for items not listed under exclusions.
The following medical supplies and equipment lists contain the products and services provided as eligible benefits by the non insured health benefits nihb program along with information on coverage policies benefit codes requirements for prior approval and applicable recommended replacement guidelines.
Please note that all nihb policies and requirements for coverage apply.
