Main Office:
780-891-2000
Corporate Office:
780-341-2777

Main Office:
Tel: 780-891-2000
Toll Free: 1-877-767-7060
Fax: 780-891-2623
email: info@bigstonehealth.ca

Corporate Office:
Tel: 780-341-2777
Fax: 780-444-6521
email: info@bigstonehealth.ca

Bigstone  Health  Benefits

Non-Insured-Health-BenefitsBigstone 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 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; and
  • Will maintain health, prevent disease, facilitate early detection of disease, and management of illness, injury or disability.

The purpose of this webpage 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:

16310 100 Avenue

Edmonton, Alberta T5P 4X5

Phone: (780) 341-2777

Toll Free: 1-866-891-9719

Fax: (780) 444-6521

Vision Care Optical Extension 4001

| Direct Line: (780) 341-2780

Dental Extension 4168

| Direct Line: (780) 481-4261

Pharmacy and Medical Supplies Extension 4025

| Direct Line: (780) 341-2776

Mental Health Extension 4021

| Direct Line: (780) 341-2783

Bigstone Health Benefits Supervisor Extension 4021

| Direct Line: (780) 341-2783

Monday to Friday 8:00am to 7:00pm closed statutory holidays

All benefits being covered by the program must be medically justified. This is demonstrated by producing documents related to the benefit.

The 5 benefit areas are:

VISION

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).

DENTAL

  • 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.

PHARMACY

  • Drug delivery devices, required to administer medications covered by the Health Benefits program when the drug delivery devices are integral to the drug product.

  • Extemporaneous mixtures/compound prescriptions

  • injectable drugs; including injectable allergy serums

  • over the counter medications

  • prescription drugs

  • recognized non-oral contraceptive devices

  • special formularies for chronic renal failure and palliative care patients and

  • therapeutic vitamins and minerals

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.

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

MEDICAL SUPPLIES AND EQUIPMENT

  • 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

  • Chiropractic Sessions

SHORT-TERM CRISIS INTERVENTION MENTAL HEALTH COUNSELLING

The STCIMHC benefit provides up to a maximum of 15 one-hour individual sessions per mental health crisis over a 20 week period. Eligible billable services under the STCIMHC benefit may include:

  • Initial assessment (maximum of 2 one hour sessions) performed by an enrolled provider; and

  • The Benefit is intended to support the provision of immediate psychological and emotional care to individuals in significant distress to stabilize their condition, minimize potential trauma from an actual life event, as appropriate, transition them to other mental health supports.