The Non-Insured Health Benefit program or NIHB for First Nations and Inuit patients does cover orthodontic treatment, but only in quite limited cases.
The NIHB program for First Nations patients has reduced the number of people covered over the past years. The program now covers only situations where there is a severe and what they call a functionally limiting malocclusion. This means that not only do you have to have really crooked teeth, but this has to produce a significant problem with chewing and speaking.
The program only covers people up to the age of 18. Your treatment can go past that, but you have to apply for treatment before the age of 18.
The program’s guidelines specifically exclude the appearance of your teeth, cases where self-esteem is affected by your teeth and problems with the jaw joint. These things aren’t covered by the program.
This program is administered by the government. As orthodontists in practice and treating people, we have no say in whether a person is covered. The people who do make these decisions are doing the best they can with the limited funding that every program has.
We’re happy to see you and talk about your orthodontic situation. We can let you know if NIHB coverage is a possibility and collect the orthodontic study records that need to go in to the program for them to consider covering your treatment.
The rules in Manitoba and Ontario are slightly different. For people in Ontario, for us to see you to apply for NIHB funding, your dentist has to start the paperwork with them and then we can see you for that first visit and take it from there.
For people in Manitoba, you must be seeing your dentist regularly and be cavity-free for six months with good oral hygiene. If you have a cavity, you’ll have to wait six months until we can see you for that first appointment to get things started. Oral hygiene, as documented in the photographs sent to the program administrators, is a factor in the decision of whether your orthodontic treatment is covered by NIHB. During the waiting period, if your dentist wants an opinion from the orthodontist, we can certainly do an examination, but cannot begin treatment.