Bigstone Health Benefits

Bigstone health benefits are an inherent right for registered treaty status indians as defined by the indian act and are constitutionally protected. The benefits are to be comprehensive, accessible and provided as needed in a timely manner to all registered treaty status bigstone cree nation members living on reserve and off reserve and who are ordinarily resident in canada.

The national NIHB and BHB do not pay for medically justified products and services for Treaty Status Indians residing outside of Canada.

The Bigstone Health Benefits program draws its authority from the Federal Government, the 1979 Indian Health Policy and the renewed mandate of 1997.  BHB follows the national guidelines, policy, procedure and mandate.  The program is needs-based which covers some of the cost for medically justified products and services that are not covered by Provincial, Territorial or any other third-party Health Plans.  Bigstone Health Benefits complements Alberta Health Care benefits such as Doctor’s visits and hospital services.

 

The Goals and Objectives of Bigstone Health Benefits are to provide benefits to registered Bigstone Cree Nation membership in a manner that:

  • Is appropriate to unique health needs
  • Contributes to the achievement of an overall health status that is comparable to that of the Canadian population as a whole
  • Is sustainable from a fiscal and benefit management perspective
  • Will maintain health, prevent disease, facilitate early detection of disease, and management of illness, injury or disability.

The purpose of this web page is to provide Bigstone Cree Nation members with important information about the Bigstone Health Benefits program.  It explains procedures in accessing products and services; who to contact, what is covered, who provides the service, how to access benefits and what your responsibilities are as a client.

All goods and services eligible under the Bigstone Health Benefits (BHB) program must receive prior approval with an attached prescription from a licensed Medical Doctor or Specialist.

Bigstone Health Benefits Contact Information
  • ADDRESS: 16310 100 Ave Edmonton, Alberta, Canada T5P4x5
  • PHONE: 780-341-2777
  • FAX: 780-444-6521
  • TOLL FREE: 1-866-891-9719
VISION CARE OPTICAL
  • EXTENSION 4001
  • DIRECT LINE: 780-341-2780
  • Monday - Friday 8:00AM to 5:00PM
DENTAL
  • EXTENSION 4000
  • DIRECT LINE: 780-481-4261
  • Monday - Friday 8:00AM to 5:00PM
PHARMACY AND MEDICAL SUPPLIES
  • EXTENSION 4023
  • DIRECT LINE: 780-341-2776
  • Monday - Friday 8:00AM to 7:00PM
MENTAL HEALTH
  • EXTENSION 4021
  • DIRECT LINE: 780-341-2783
  • Monday - Friday 8:30AM to 4:30PM
BHB SUPERVISOR
  • EXTENSION 4021
  • DIRECT LINE: 780-341-2783

What is covered?

Eye exams: routine

  • Every 2 years for ages 19 to 64.
  • Diabetic clients:  major annual eye exam

Replacement eye glasses/lenses

  • Every 24 months for a person 18 years old and over.
  • Every 12 months for a person younger than 18 years.
  • Replacement lenses within the 24 month period if there is a significant change in vision.

Repairs

  • The total cost of the repair must not be more than it would cost to replace with standard frames.
  • One major and one minor within the eyeglasses replacement time frame (12 or 24 months).
  • Diagnostic services (exams & x-rays)
  • Preventive services (cleanings)
  • Restorative services (fillings)
  • Endodontic services (root canals)
  • Periodontal services (deep cleanings)
  • Prosthodontic services (removable dentures)
  • Oral surgery services (extractions, removal of teeth)
  • Adjunctive services(general anesthetic, sedation)
  • Orthodontic services (braces)

Dental services covered under the bigstone health benefits program are divided into two (2) schedules;

Schedule a – these are categories of dental services that do not require predetermination but may have frequency limitations.

Schedule b – these are categories of dental services that require predetermination.

Remember – the rules about what is covered may vary by region depending upon provincial/territorial insured services.

  • Prescription medications
  • Over-the-counter medications
  • Injectable drugs including injectable allergy serums
  • Extemporaneous mixtures (compounded medications)
  • Drug delivery devices, as required, to deliver medications 
  • Recognized non-oral contraceptive devices
  • Therapeutic vitamins and minerals
  • Special formularies for; Clients with chronic renal failure, Clients who are diagnosed with a terminal illness and are near the end of life and For Adjunct Medications Used During Active Cancer Treatment

The NIHB drug benefit list consists of 5 different sections:

Open benefit drug – these drugs are a benefit without having to issue prior approval.

Limited use benefits – these drugs have been found effective in specific circumstances therefore, will have to go through a process before being approved.

Chronic renal failure – these certain drugs are specifically for chronic renal failure patients.

Palliative care – clients diagnosed with a terminal illness and are near the end of life will be eligible to receive coverage for a list of supplemental benefits. These medications are used to provide comfort to those near the end of life.

Clients undergoing active cancer treatment have access to adjunctive (non-chemotherapy) medications

Exception drugs – these items are not on the drug benefit list but coverage may be considered if medically justified and is situational.

The full nihb drug benefit list can be viewed by visiting:

http://www.hc-sc.Gc.Ca/fniah-spnia/nihb-ssna/provide-fournir/pharma-prod/med-list/index-eng.php

  • Audiology equipment (e.g. Hearing assessments and hearing aids)
  • Medical supplies & equipment (e.g. Bathing and toileting aids, dressing aids, feeding aids, lift and transfer aids, walking aids, wheelchair and wheelchair cushions, ostomy supplies and devices, urinary supplies and devices, wound dressing supplies, low vision aids)
  • Orthopedics and custom-made footwear
  • Oxygen and respiratory supplies and equipment
  • Pressure garments
  • Prosthetics

 

Every 12 months, an eligible client can receive up to 22 hours of counselling performed by an enrolled provider on a fee-for-service basis .

The Benefit is intended to provide coverage for the immediate psychological and   emotional care to individuals in significant  distress to stabilize their condition, minimize potential trauma from an acute life event, and, as appropriate, transition them to other mental health supports.

DOWNLOADABLE FORMS

BHB PROVIDERS MAP