Non-Insured Health Benefits (NIHB)

Provider Guide for Pharmacy Benefits

The Provider Guide for Pharmacy Benefits contains information about the services and policies for NIHB beneficiaries and the Drug Benefits List contains drugs eligible for NIHB clients. Claims for NIHB patients are adjudicated through Express Scripts Canada for more information click here.

To be eligible under the NIHB Program, extemporaneous mixtures must have at least one ingredient listed on the Drug Benefits List and must not duplicate the formulation of commercially manufactured drug products. Mixtures that contain exception or 'limited use' drugs must receive prior approval by the NIHB Drug Exception Centre; those that contain ingredients excluded from the Program will not be eligible for coverage.

For more information, please contact the Provider Claims Processing Call Centre at 1-888-511-4666 to speak with an ESC Representative.

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