Fluoride Treatment Added and Approvals Streamlined For Multiple Health Benefits

1/17/2019

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All clients of the First Nations Health Benefits (FNHB) program are eligible for fluoride treatment now that coverage has been extended to adults age 17 and older. Previously, fluoride treatment coverage was only available for children age 16 and younger.

The program has also removed the prior approval requirement for minimal dental sedation as well for the purchase or rental of numerous medical supplies and equipment (MS&E). In addition, coverage is now available for a number of MS&E items that had previously only been covered as exceptions following case-by-case reviews.

These changes are expected to increase access to these services and items as well as reduce processing times for benefit approvals. Read below for details about the health benefits changes.


NEW BENEFITS

Dental

• Fluoride treatments for adults age 17 and older

Clients in this age group are eligible for one fluoride treatment per 12-month period. (Fluoride treatment is already covered for children aged 16 and younger.)

 

CHANGES TO BENEFITS

Open Benefits (no prior approval required when the following are provided according to the guidelines)

Dental

• Dental Sedation (minimal) - Nitrous oxide and oral sedation


Medical Supplies and Equipment (MS&E)

• Battery-powered portable bath lifts

• Electronic blood pressure (BP) monitors (when prescribed by a physician, nurse practitioner or registered midwife)

• Gender-affirming items, including packers and upper and lower body garments

• Nipple shields for nursing mothers

• Off-the-shelf limb and body orthotics, including splints and braces

• Mobility and personal care items:

o Bath chair

o Commode, standard

o Elevated raised toilet seat with arms

o Floor to ceiling pole

o Grab bar bed purchase

o Safety frame for toilet

o Tub transfer bench

o Walker standard, purchase

o Walker 2-wheel, purchase

o Walker 4-wheel, purchase

o Walker bariatric, purchase

o Wheelchair manual, purchase

 

Full Benefits With Prior Approval

Medical Supplies and Equipment (MS&E)

• Bi-Level and Auto-Continuous Positive Airway Pressure Systems (BPAP and APAP)

• Custom foot bed liners

• Offloading walking and diabetic walking boots

• Orthosis for club foot

• Oxygen-conserving devices (rental)

• Wheeled commodes (for purchase)

If you have questions or need more information, please contact First Nations Health Benefits at 1-800-317-7878.