FNHA accepted responsibility for the delivery of Health Benefits on July 2, 2013, when FNHA began receiving transfer payments from Health Canada for the continuation of the Non-Insured Health Benefits (NIHB) program.
At the same time, FNHA entered into what we refer to as a "buy-back" arrangement with Health Canada. This arrangement provides continued access to the NIHB program's benefits and a seamless transition of responsibility to FNHA.
The buy-back arrangement with Health Canada provides time for FNHA to prepare the systems and structures to safely transition the Health Benefits program to First Nations ownership and control.
Taking this responsibility was the first step in a phased approach to FNHA transforming its Health Benefits program. FNHA has changed how it supports Health Benefits by focusing on supporting FNHA Clients with their health and wellness, emphasizing health prevention, and incorporating cultural humility and cultural safety.
Although FNHA took responsibility for Health Benefits in July 2013, some benefit areas are still being administered by Health Canada through buy-back. The Claims Processing System Transition (CPST) Project will eventually transition all Health Benefits from Health Canada to FNHA control.
The goals of the CPST Project are based on the direction provided through the Tripartite Agreement signed by BC First Nations, the Province of BC, and the Government of Canada.
The CPST project is establishing partnerships to move from federally controlled systems to local and provincial systems. This will position FNHA to deliver on its mandate of transforming the delivery of health care, improving the health and well-being of BC First Nations.
The ongoing transition will take time. A foundational principle guiding our work is to ensure no gaps in service as BC First Nations are moved from Health Canada to an FNHA Health Benefits Program. Our goal is to create a program which better reflects the cultures and perspectives of BC First Nations, and incorporates First Nations' models of wellness.
Guided by the Tripartite Agreement, and our commitment to avoid parallel or duplicate services, we have entered into an Agreement with the BC Ministry of Health's PharmaCare program. Our plan is to transition to PharmaCare and to develop a first-of-its-kind provincial First Nations drug benefit plan.
We want to leverage provincial systems, where possible, so BC First Nations can access benefits in the same way as all other British Columbians – breaking down barriers to care, while considering the unique needs of First Nations.
PharmaCare is the provincial government's drug insurance program. It helps BC residents with the cost of eligible prescription drugs, certain medical supplies, and pharmacy services. It provides assistance through several drug plans. By joining PharmaCare, First Nations will be part of the largest and most well-established drug insurance program in BC.
You are eligible for coverage under the new FNHA PharmaCare plan if you:
• are a resident of British Columbia, and• have active Medical Services Plan (MSP) coverage, and• are a status Indian under the Indian Act, or a child of less than one (1) year of age, at least one of whose parents is a status Indian under the Indian Act.
• are a resident of British Columbia, and
• have active Medical Services Plan (MSP) coverage, and
• are a status Indian under the Indian Act, or a child of less than one (1) year of age, at least one of whose parents is a status Indian under the Indian Act.
Individuals who receive health benefits by way of a First Nations organization pursuant to self-government agreements, land claim agreements, or contribution arrangements are not eligible for coverage under the new FNHA PharmaCare plan.
If FNHA currently pays MSP premiums on your behalf, you will automatically become a beneficiary of the PharmaCare program. If you are receiving FNHA Health Benefits but FNHA does not pay MSP premiums on your behalf, you will need to contact FNHA before receiving pharmaceutical benefits through FNHA and PharmaCare.
If you have any questions about your eligibility, contact our FNHA client support representative at 1-855-550-5454.
First Nations in BC will become beneficiaries of the PharmaCare program on October 1, 2017.
Your status card and your BC Services Card (or CareCard) will be all that you need to access your drug benefits under the PharmaCare program. If you do not already have a BC Services Card (or CareCard), you will need to obtain one before you can receive benefits through PharmaCare.
For more information, please call our FNHA client support representative at 1-855-550-5454.
Yes, if FNHA currently pays MSP premiums on your behalf, this will continue.
MSP is the provincial insurance program that pays for required medical services. These include medically necessary services provided by physicians and midwives. Some examples of the services covered by MSP are:
• maternity care provided by a physician or a midwife;• medically required eye examinations provided by an ophthalmologist or optometrist; • diagnostic services, including x-rays, provided at approved diagnostic facilities, when ordered by a registered physician, midwife, podiatrist, dental surgeon or oral surgeon
• maternity care provided by a physician or a midwife;
• medically required eye examinations provided by an ophthalmologist or optometrist;
• diagnostic services, including x-rays, provided at approved diagnostic facilities, when ordered by a registered physician, midwife, podiatrist, dental surgeon or oral surgeon
PharmaCare is the provincial government's drug insurance program. It helps with the cost of eligible prescription drugs, certain medical supplies, and pharmacy services. It provides assistance through several drug plans, including a plan designed with FNHA clients in mind.
FNHA manages your Health Benefits plan and is building close partnerships with other service providers. Once the administrative transition is complete, we will be better positioned to transform benefits to reflect the unique needs of all FNHA clients with a commitment to improve service. FNHA is engaged with communities to ensure the program changes increase First Nations ownership and control.
The new FNHA Health Benefits system will not require you to get a new CareCard. However, BC Services Cards are now being issued with the goal of eventually replacing all existing CareCards by February 2018.
The newer BC Services Cards have enhanced security features to help protect personal information and we encourage all FNHA clients to obtain the new BC Services Card by summer 2017. The cards can be obtained from an ICBC driver licensing office or by contacting Service BC toll free at: 1-800-663-7867. For more information about the BC Services Card, please visit www.gov.bc.ca/bcservicescard.
It will remain your choice to remain in or opt out of your private, employer-sponsored or other public health care coverage, just as it currently is. However, by opting out, some of the benefits you receive through your private insurance coverage may not be eligible benefits under FNHA Health Benefits (e.g. physiotherapy and chiropractic treatment).
You will continue to receive the care and treatment you require.
You may notice some small changes. For example, there may be differences in the brands of drugs that will be covered.
Additional information on the changes and those affected will be available before the transition.
It will be important to change to a drug that PharmaCare covers as soon as it makes sense to do so; you can make this decision with your health care provider based on what is best for you. If you and your health care provider decide that only a specific drug meets your needs and it is not covered, your health care provider may be able to request PharmaCare Special Authority coverage for you.
Yes, however you may need to fill your prescriptions before travelling.
Currently, pharmaceutical benefits for FNHA clients are provided by Health Canada and the Non-Insured Health Benefit (NIHB) program through buy-back. NIHB is a federal program, which means it can offer coverage for prescriptions filled in other provinces. PharmaCare is a provincial program, so it cannot cover prescriptions filled outside of BC.
If you are travelling outside of BC, make sure you plan ahead to ensure you have enough medication for your trip. Normally, PharmaCare does not cover a refill unless you have less than a 14-day supply of medication left. However, if you plan to travel, you can "top up" your prescription to the maximum days' supply PharmaCare covers at any time. At the pharmacy, you will be asked to sign a Travel Declaration Form, which your pharmacist will provide. You can use this early top-up option only once every 6 months.
If you are travelling outside of BC for an extended period of time, you may need to fill your prescription at an out-of-province pharmacy and be reimbursed upon your return to BC. FNHA is developing a reimbursement process for prescriptions filled out-of-province.
FNHA Clients travelling outside of Canada may continue to be eligible for coverage of their premiums for out of country health insurance. To obtain premium coverage for travel outside of Canada, you must obtain prior approval by contacting FNHA Health Benefits.
Traditional medicine and healing are future considerations. Our immediate focus is completing the transition from Health Canada systems to locally driven and influenced processes, which will better serve FNHA clients. Once the transition is complete, we'll be better positioned to transform benefits to reflect the cultures and perspectives of BC First Nations and incorporates First Nations' models of wellness.
Yes. However, your FNHA PharmaCare plan will be the main plan that you use to access coverage for prescription drugs.
Individuals can be enrolled in multiple PharmaCare plans, however these plans are for patients with specific health care needs (e.g. Palliative Care). Your doctor or nurse practitioner will ensure you are enrolled in the PharmaCare plans you are eligible for.
If you have questions or need support with FNHA Health Benefits, call our FNHA Client support representative at 1-855-550-5454.
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