About this Benefit
For many First Nations people, especially those living in rural or remote areas, it can be challenging to access necessary medical care. Health Benefits offers supports to help with these challenges through the medical transportation (MT) benefit.
Health Benefits works with First Nations communities to deliver the MT benefit. Community Patient Travel Clerks or FNHA Assessors are your connections to help you access your MT benefits.
What My Plan Covers
Your MT benefits provide assistance with the cost of
meals,
accommodation and
transportation to help you travel to a medical appointment outside your community of residence. MT coverage is intended as a supplement and may not cover the full cost of your travel.
You can access medical transportation benefits if you are traveling to:
- medical services covered by MSP or a public health agency
- services eligible under the Health Benefits Program (e.g., dental, vision, etc.)
- traditional healers
- treatment at an FNHA funded facility for substance use (formerly NNADAP)
MT benefits covers travel to the closest appropriate provider, using the most efficient and economical type of transportation appropriate for your needs and medical condition.
Meal Rates
Meal Rates for Medical Transportation increased on October 1:
Fee Schedule for Meal Rates
|
| | Old Rate | New Rate from Oct 1st 2021 |
| Daily Rate for trips more than 6 hours but not overnight | $15.10 per client | $15.10 per client |
Nightly Rate for trips up to 6 nights
| $25.00 per night per client under nine years old
| $25.00 per night per client under five years old
|
| $53.10 per night per client nine+ years old | $60 per night per client five years old and over |
| Weekly Rate for trips 7 nights or more | $222.20 per week inclusive of escorts | $236 per week inclusive of escorts |
COVID-19 Isolation Support
Meal and Accommodation Supports for Self-isolation Related to COVID-19
The FNHA continues to provide the following supports for status First Nations individuals who are advised to self-isolate by a healthcare provider for reasons related to COVID-19:
- Meal supports for individuals required to self-isolate
- Alternative accommodation for people who cannot self-isolate at home, including meals and travel
This support is available for isolation dates between January 12 and March 31, 2022.
Call 1-888-305-1505 if you have been advised to self-isolate and need support to cover meals and accommodation expenses. Service hours are Monday–Friday from 8:30 a.m. to 4:30 p.m., and Saturday–Sunday from Noon–4 p.m.
How Do I Access Coverage?
Most clients should contact their community’s Patient Travel Clerk to access medical transportation benefits. If your community does not have a Patient Travel Clerk or you do not know who to contact, call Health Benefits at
1-855-550-5454.
1. Submit a
Medical Transportation Request Form at least 5 business days before your trip to get prior approval before travelling. You will also need to submit
written confirmation of your appointment from your provider. If you do not get prior approval for your trip, or if you do not submit your request form ahead of time, you may have to reschedule your appointment or pay for your travel costs yourself and then request reimbursement.
2. Your community Patient Travel Clerk makes you travel arrangement and sends you the details.
3. Attend your appointment as scheduled.
4. After your trip, submit a
written confirmation of attendance. You must provide confirmation from your provider that you attended your appointment. If you need to request reimbursement, you will need to submit your written COA with your request. Clients who do not attend their appointment may be asked to pay back the cost of their travel.
If you have any questions about your medical transportation benefits, how to access coverage, or why a claim was denied,
call Health Benefits at 1-855-550-5454.
Escorts
If you need someone to accompany you on your trip to your appointment, you may be eligible to travel with an escort. Escorts are covered under certain conditions, including if you:
• are a minor
• need help with activities of daily living (eg, dressing, eating, or bathing)
• are undergoing a medical procedure (eg, day surgery) or have a medical condition that means you need help to get home
• will face a language barrier
• are travelling to give birth
You may be asked to provide
documentation from your health care provider to show you need an escort.
What My Plan Does Not Cover
Some types of travel are Exclusions. Exclusions cannot be covered as an exception and cannot be appealed. MT benefit Exclusions include, but are not limited to:
- compassionate travel (eg, travelling to visit a family member who is receiving medical treatment)
- payment of fees for a doctor’s note
- travel back to your community of residence if you became sick or injured while away from home
- travel when the medically-necessary service is available in your community
- travel to access medical appointments located outside of Canada
- travel to access services that are not considered medically necessary
- travel where the only purpose is to pick up items that do not need to be fitted (eg, prescriptions, prescription glasses or contacts and some medical supplies and equipment).
You can call Health Benefits at 1-855-550-5454 to learn more about what is covered.
Appeals
When a coverage request for travel 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.
Client Forms
The forms below are for clients whose travel is being arranged by Health Benefits. If a Patient Travel clerk is arranging your travel contact them for the appropriate forms.
Medical Transportation Check List
Medical Transportation Request Form
Medical Transportation Confirmation of Appointment Form
Medical Transportation Escort Form
Medical Transportation Confirmation of Attendance Form
