Provincial Health Plans > New Brunswick Health Plan
Medicare: Summary of Benefits and Coverage Overview
The New Brunswick Health Care plans like Medicare (for major medical and hospital services coverage) and New Brunswick Prescription Drug Program (NBPDP) (for prescription drug coverage) are the provincial health benefits for the New Brunswicker. You can take advantage these benefits if you are a permanent resident and have lived in the province for a minimum of six (6) months a year.
Here is an overview of the benefits offered by the plan:
The following services provided by an insured practitioner will be covered by Medicare.
- • Majority of the medical services offered by a physician in a hospital or a physician’s office.
- • Some dental procedures provided they are medically necessary and are carried out within a hospital. However, extractions and dental work performed in a hospital are not insured but in some cases, anesthesia may be covered.
Non-preapproved emergency medical costs that accrue while traveling outside Canada are not insured.
The following hospital services are covered:
- • Medically required nursing services.
- • Meals and standard hospital rooms.
- • Routine surgical supplies administered in a hospital.
- • Drugs administered in a hospital.
- • X-rays, laboratory services and other diagnostic services.
- • Radiotherapy and therapies administered while in a hospital such as speech therapy, occupational therapy, and
- • Services in anesthetic facilities, operating rooms, and delivery rooms.
Costs and Services Not Covered by Medicare
The following costs are not covered by Medicare:
- • Annual checkups.
- • Ambulance services.
- • Regular dental services and dentures such as extractions, fillings, and cleanings as well as examinations. If a dental procedure is deemed medically necessary, it may be covered if it is carried out by a dentist in an approved hospital.
- • Medicines and prescription drugs. People who are covered by one of the aforementioned drug plans may be covered.
- • Examinations for employment, travel purposes, etc requested by a third party.
- • The services of acupuncturists, chiropodists, massage therapists, chiropractors, naturopaths, osteopaths, pharmacists, physiotherapists, private nursing and psychologists.
- • The services of opticians and optometrists.
- • Contact lenses, eye glasses, frames, and eye examinations.
- • Cosmetic surgeries.
- • Artificial insemination.
- • Removal of minor skin lesions such as warts.
- • Medical equipment such as special crutches, walkers, prosthetics devices and so forth.
- • Applied researches and services considered by as an experiment by the province.
- • Reversal of sterility processes.
- • Renewing prescription over the phone or physician advice.
- • Dental services provided they are rendered by a physician.
- • Gastric bypass and staples as well as other stomach stapling.
- • The cost difference between private and semi-private hospital rooms when compared to the cost of the standard
- • Immunization obtained through public health clinics unless the service is considered to be medically essential and carried out by a physician.
Drug Plan in New Brunswick
Residents who do not have drug coverage through a private health insurance plan can take advantage of the New Brunswick drug plan.
Further, residents who enroll in this plan are required to pay some premiums. The premiums are determined based on the annual income of the family. You are required to be covered by Medicare to be qualified for this plan.
The New Brunswick Prescription Drug Plan (NBPDP)
Prescription drugs are not part of the services or costs covered by Medicare. However, residents who need assistance in paying for their medications, and who have met the eligibility requirements by being in any of the eligibility groups mentioned below, can get coverage.
Here are the eligibility groups:
- • Residents living in licensed, adult residential facilities.
- • Seniors from age 65 and above.
- • Social development clients.
- • Children with special needs and children in the care of the Minister of social development.
- • Residents suffering from multiple sclerosis. Some treatment drugs are covered here.
- • Residents suffering from cystic fibrosis. Some treatment drugs are covered here.
- • People undergoing a transplant of a solid organ or bone marrow. Here, anti-rejection drugs are covered.
- • Some human growth hormone drugs.
- • Residents of nursing homes.
- • Drug coverage for residents suffering from HIV/AIDS.
New Brunswick Drugs for Rare Diseases Plan
Residents suffering from certain rare diseases can take advantage of the drug coverage. Such diseases might include Hurler and Hurler-Scheie forms of Mucopolysaccharidosis I (MPS I) , Hunter’s Syndrome, Cryopyrin-Associated Periodic Syndrome (CAPS) – Muckle-Wells Syndrome (MWS) and Neonatal-Onset Multisystem Inflammatory Disease (NOMID), infantile/early and adult/late onset Pompe disease, Mucopolysaccharidosis VI (MPS VI), and Niemann Pick Type C (NPC).
Information System and Monitoring Program for Prescription Drugs
eHealthNB shows a patients’ medication history for prescribed medications that have been provided by a New Brunswick community pharmacy. The eHealthNB functions through the Electronic Health Record (EHR) and Drug Information System (DIS).