Reimbursements

​When providers are not able to bill PBC or Health Benefits directly for eligible items and services, clients will need to pay out-of-pocket and then request reimbursement. If the cost of the item or service is more than what Health Benefits covers, clients will have to pay out-of-pocket for the remaining balance.

Dental, Vision, and MS&E Reimbursements

Reimbursement requests for dental, vision care, and MS&E items and services can be submitted electronically using the PBC Member Profile, or can be mailed to PBC. Requests must be submitted within one year from the date on which the item or service was received.

Online submission through the PBC Member Profile is recommended as reimbursement will usually occur within two business days. If clients are submitting requests to PBC by mail, they must submit the appropriate reimbursemen​t form and all original itemized receipts.​ Clients should mail PBC reimbursement requests to:

Pacific Blue Cross

PO Box 7000

Vancouver, BC V6B 4E1

Medical Transportation, Mental Health, and Pharmacy Reimbursements

Reimbursement requests for items and services under medical transportation and mental health should be submitted to Health Benefits.

Some pharmacy items and services are also eligible for reimbursement through Health Benefits. These include:

 Claims for an infant who does not yet have a Personal Health Number (PHN);

 Claims for children who do not yet have a Status Number;

 Out-of-province reimbursements that were denied by Pharmacare; and

​ Co-payment amounts charged by pharmacies that are above the amount covered by PharmaCare for the following items:

o Rapid-acting analogue insulins (Humalog, novo-rapid in the name);

o Cystic fibrosis nutritional supplements/vitamins; and

o Diabetes supplies (insulin pumps, needles and syringes, blood glucose test strips).

All requests must be received by Health Benefits within one year from the date on which the item or service was received. Clients should submit the Client Reimbu​rsement Form with all original itemized receipts to Health Benefits either by mail or fax.

Out-of-Province Pharmacy Reimbursements

Reimbursement requests for eligible pharmacy items filled outside of BC should be mailed to PharmaCare. Submit all original itemized receipts and prescriptions with the PharmaCare Out-of-Province Client Reimbursement Form. Mail requests to:

Health Insurance BC

PO BOX 9684 STN PROV GOVT

Victoria, BC V8W 9P7

 Do you have questions?

Contact us at 

HealthBenefits@fnha.ca 

or call

1-855-550-5454 (Toll Free)​​​

 How was your experience?

We want to hear from you about your experience with FNHA Health Benefits. Please take 5-10 minutes to fill out our survey here:

Feedback 

This client satisfaction survey will help us understand BC First Nations experiences accessing FNHA Health Benefits. We will use this information to improve the quality of our services.

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