The First Nations Health Authority is announcing several changes within the Health Benefits plan.
Effective April 17, 2023, the First Nations Health Authority (FNHA) is launching an updated Medical Transportation (MT) Benefit Schedule. The updates include:
Based on the feedback from communities across the province, the FNHA has clarified the language for the Closest Appropriate Provider and the conditions for Exception coverage requests. These changes include:
Requests for Escort for Clients in Hospital continue to be evaluated on a case-by-case basis. Claims submitted through the Exception process focus on the unique condition of each client and the medical need for an Escort while a Client is in the hospital. These changes include:
The FNHA Team has developed a User Guide to support PT clerks in evaluating client eligibility, assessing benefits and booking travel. The guide will supplement the Benefit Schedule along with training already provided.
Effective April 1, 2023, the FNHA extended the Temporary MT mileage rate of $0.29 until Sept. 30, 2023. Learn more.
Effective April 17, 2023, there will be changes to the following:
The existing $4,500 per five-year review threshold remains in place, in addition to the changes listed above. Any approved pre-determinations prior to the change will be honored. Your dental provider will have information about approved pre-determinations and any existing treatment plan that is in place.
For more information, please visit the PBC app or call Health Benefits 1-855-550-5454.
The FNHA provides pharmacy benefits for First Nations people in British Columbia (BC) through partnership with BC PharmaCare and PBC. PharmaCare Plan Wellness (Plan W) is the drug benefit plan for FNHA clients.
The FNHA continues to work with its partners to improve pharmacy benefits to meet the unique health needs of First Nations people in BC.
The following are recent changes to Plan W coverage and pharmacy benefits:
Clients are encouraged to have annual medication reviews with their pharmacist to discuss their chronic medications, make sure the medications are working well, and improve understanding of their medication regimens. Clients who do not have access to a trusted local pharmacist can set up a phone or video appointment to speak with a pharmacist.
For more information, please contact Health Benefits at 1-855-550-5454.