1.00 INTRODUCTION
The Nunavut Health Care Plan offers similar coverage and benefits to health care plans in
other provinces and territories (OHIP, Manitoba Health, etc). There are various
supplemental plans that provide additional coverage where necessary.
2.0 ELIGIBILITY
Any legal resident of Canada living in Nunavut can register for a Nunavut Health Care
Card, with the following exceptions:
The following individuals cannot register for Nunavut Health Care Cards:
Tourists, transients and visitors to Nunavut.
Students whose permanent residence is in another province or territory.
Temporary workers (365 days or less).
Members of the RCMP and Armed Forces (although their family members can
register while living in Nunavut).
Certified Refugees or Refugee Claimants
3.00 ADMINISTRATION
The Department of Health & Social Services is responsible for registering all permanent
residents of Nunavut for territorial health care coverage through the Health Insurance
Programs (HIP) office which is located in Rankin Inlet. Clients registered with the
Nunavut Health Care Plan are eligible for insured services and may also be eligible for
supplementary health benefits under other programs.
3.01 Registration
The role of the Registration section is to:
a) Hospital Costs
The Nunavut Health Care Plan pays for inpatient and outpatient services
in approved public facilities for residents of Nunavut who hold valid
Health Care Cards.
The Nunavut Health Care Plan covers physician service fees for those
residents holding valid Nunavut Health Care Cards.
Date of service
Fee for service code
Diagnosis
All physicians, whether on contract or fee for service, are required to fill
out fee for service documentation for each patient encounter. Currently
the information is collected on a physician’s claim card, which is then
submitted to a billing clerk for processing.
d) Dental Treatment
In general the Health Care Plan does not provide assistance with dental
treatment unless it is related to a jaw injury, TMJ problem or disease.
There is a limited amount of assistance available to EHB, IHB and NIHB
recipients.
Approval Number’s are required prior to travel for all Orthodontic and
GA travel.
a) Procedures or Treatments
The Nunavut Health Care Plan will only consider coverage of certain
procedures or treatments, based on the mandatory prior approval process
having been completed (i.e. procedures by an oral or plastic surgeon). To
obtain prior approval, a letter must be written by the requesting physician
justifying the requirement for the specific treatment or procedure. This
letter should contain as much information as possible including a general
estimate of costs. Once the letter is received, the request is sent to a
medical advisor for consideration. If you are unsure as to whether or not a
procedure will be covered by the HCP, please contact Health Insurance
Programs.
b) Private Facilities
A number of southern jurisdictions have begun to out-source certain
patient services to private clinics. Therefore, the HCP will consider
coverage of private facility charges in special circumstances, based on the
mandatory prior approval process having been completed.
c) Reimbursements
Personal reimbursements will be reviewed upon submission of
substantiating original documentation to the HIP office.
d) Allowable Benefits
The following are benefits under the Nunavut Health Care Plan:
* A private clinic may be used if prior approval has already been granted by the DH&SS
e) Non Benefits
The following are not benefits of the Nunavut Health Care Plan:
Experimental Procedures/Surgery No No No
Massage Therapist No No No
Naturopath No No No
Optometrist No Yes No
Orthodontist No Yes** No
Osteopath No No No
Podiatrist No No No
This is only a general list of what the Nunavut Health Insurance Plan does and does not
cover.
Once an individual moves to a new province or territory they should apply for
health care coverage within the first 3 months of residence.
For additional information about the Nunavut Health Care Plan contact the Department of
Health and Social Services at: