About this Benefit
Counselling is a tool for individuals experiencing a difficult situation to resolve their emotional distress and enjoy greater wellness.
Health Benefits has partnered with Pacific Blue Cross (PBC) to administer the Mental Wellness and Counselling (MWC) benefit to First Nations in BC. You can access the Mental Health Benefit Schedule here.
For more information about the updates to the Mental Wellness and Counselling program, please see a Client frequently asked questions resource here.
What My Benefit Covers
Your benefit covers counselling services from a qualified mental health provider. Mental health providers include psychologists, clinical counsellors and social workers.
The mental health provider must be registered with Health Benefits. Options to find a registered mental health provider:
- Call Health Benefits at 1-855-550-5454;
- Browse the Health Benefits Mental Health Provider List;
- Browse the mental health provider map below (see the Mental Health Provider Map Guide for instructions on how to locate a mental health provider using the map):
You can find detailed information about your mental health claims through your PBC Member Profile, which you can access online.
How Do I Access Coverage?
You must see a provider who is registered with the Health Benefits Program to receive coverage for your counselling services.
If you need travel assistance to access counselling, please contact the Medical Transportation Program (email: Transportation@fnha.ca ; phone: 1-855-550-5454).
Note: Medical Transportation coverage may be available for trips that meet Medical Transportation criteria. Learn more about your Medical Transportation benefits here.
If you prefer virtual appointments, talk to your provider about Telehealth options. See the Telehealth page or the Telehealth for Mental Health poster.
1. Tell your provider that you have coverage through the Health Benefits Program when scheduling your first appointment.
2. Your first appointment is about determining if the provider is the right fit for you. You can change to another registered provider at any time.
3. Cancel your appointment ahead of time if you can no longer make it. Health Benefits does not pay for missed appointments and your provider may charge you for the cost of your appointment if you do not show up.
If you have any questions about your mental health benefit, how to access coverage, how to find a mental health provider or why a claim was denied, call Health Benefits at 1-855-550-5454.
What My Benefit Does Not Cover
Some services are considered Exclusions. Exclusions cannot be covered as an exception and cannot be appealed. Some examples of common mental health Exclusions are:
- services for children under the age of six
- psychiatric emergencies for people at risk of harm to self or others
- services funded by another program or agency (eg, psychiatric services through BC MSP counselling provided to incarcerated clients)
- services for the purpose of a third party (eg, school application, employment assessment, to support legal action, child custody, etc)
- Telehealth through instant messaging or emails
You can call Health Benefits at 1-855-550-5454 to learn more about what is covered.
Appeals
When coverage for a mental health service has been denied, you have the right to appeal the decision. Items and services that are Exclusions cannot be appealed. See the Appeals page for more information about the appeals process.
Compliments and Complaints
Mental Health providers like all other regulated health professionals in BC, are required to practice with cultural safety and humility. If you have feedback on your experience or interaction when receiving care, you can contact FNHA's Quality Care and Safety Office.
