Health benefits for First Nations, Inuit and Métis people

What these benefits are

The federal government runs a health benefits program for First Nations and Inuit people called Non-Insured Health Benefits, or NIHB. "Non-insured" means it pays for the things provincial health insurance leaves out.

Indigenous Services Canada lists six areas of coverage:

• prescription drugs,
• dental care,
• vision care,
• medical supplies and equipment,
• mental health counselling, and
• medical transportation.

Those are things most people in Victoria either pay for themselves, buy insurance for, or go without. If you are eligible, you should not be going without them.

BC is different, and this trips people up

This is the most important paragraph on the page.

In every other province, eligible people deal with the federal NIHB program directly. In British Columbia they do not. Since a transfer agreement between Canada, BC and BC First Nations, the First Nations Health Authority runs the health benefits program for First Nations people who live here. Indigenous Services Canada's own eligibility page says so: First Nations residents of BC who are clients of the First Nations Health Authority get their coverage from FNHA rather than through the federal program.

What that means for you in practice:

• You enrol with FNHA. You are not automatically in it because you have a status card. Enrolling is a phone call.
• You phone 1-855-550-5454, not a federal number.
• Your prescriptions run through BC PharmaCare Plan W, which the pharmacy bills directly.
• Appeals go to FNHA in Vancouver, not to Ottawa.

Who is eligible

These rules are set by federal registration law. They are not about how you were raised or who your family is. They are about what is written in the Indian Register or in a land claim organisation's list, and you need to know them so you know what you can claim.

For the federal NIHB program, Indigenous Services Canada says you must be a resident of Canada and be one of:

• a First Nations person who is registered under the Indian Act,
• an Inuk recognised by one of the Inuit land claim organisations, or
• a child under 2 years old whose parent is an eligible client.

For the FNHA program in BC, FNHA says the program is for First Nations people with Indian status who live in BC, plus infants up to 24 months if at least one parent is eligible. You are not eligible if the federal government or a First Nations organisation already provides your health insurance under a self-government agreement.

Two things follow from this, and they are worth saying plainly:

• Métis people are not named in the eligibility rules for NIHB, and FNHA's program is for people with status. There is a section below on what Métis people in BC can use instead.
• First Nations people without registration are not eligible either, even where community and family say otherwise. If you think you may be entitled to register and never have, read the status section below — it can be worth doing.

What is covered

Below is what each of the six areas is for. Exactly which items, how often, and how much is paid changes over time and depends on your situation. Nobody should promise you a specific amount without checking, and neither will we. Phone before you spend money.

How to use it, step by step

1. Enrol. Phone FNHA Health Benefits at 1-855-550-5454 with your status number in front of you. If you have just moved to BC, phone anyway — you may need to confirm your enrolment here.
2. Make sure you are enrolled in MSP too. The BC Medical Services Plan covers your doctor and hospital visits. This program sits on top of it; it does not replace it.
3. Tell the front desk before your appointment, not after. Say which program you are covered by and give them your status number.
4. Ask whether the item needs prior approval. See the next section. This is the step that costs people money when it is skipped.
5. Get everything in writing. If something is refused, ask for the refusal in writing. You need it to appeal.
6. Keep your receipts even when the provider bills directly. If a claim goes wrong, the receipt is what fixes it.

When a clinic says "we don't take that"

This happens a lot, and it is usually not a refusal of coverage. It is a front-desk person who has not billed this program before, or who is thinking of the federal program because they trained in another province.

You do not have to argue. You just have to give them the phone number.

Prior approval: ask before you buy

Some things are paid automatically. Others need to be approved before you get them. The program calls this prior approval — you may also hear "predetermination", and for some medicines "special authority".

What it means for you:

• Your dentist, doctor, pharmacist or equipment supplier sends the request in. It is their paperwork, not yours.
• A decision comes back before the work is done or the item is ordered.
• If you pay first and ask afterwards, you may not get the money back. That is the trap.

So the single most useful question you can ask any provider is: "Does this need prior approval, and have you sent it in?"

If you are turned down

A "no" is not the end. Both programs have a written appeal process, and appeals do succeed — usually because more information from your health provider goes in the second time.

In BC (FNHA): you can appeal within 12 months of the date the benefit was denied. You, a parent or guardian, or someone acting for you can send it. FNHA asks for a letter that sets out your diagnosis, your prognosis, what treatments have already been tried, and why the treatment you are asking for is needed — with supporting documents such as a doctor's note or test results. Phone 1-855-550-5454 first and ask them to walk you through it.

Send FNHA appeals to:

FNHA Health Benefits Program, 701 – 1166 Alberni Street, Vancouver, BC V6E 3Z3.
Orthodontic appeals go instead to Pacific Blue Cross, PO Box 7000, Vancouver, BC V6B 4E1.

Under the federal NIHB program (which is what you would use if you are Inuit, or if you live outside BC) there are three levels of appeal. A different program official looks at each level, and a different health professional reviews it and advises. Level two goes to the regional executive of the First Nations and Inuit Health Branch; level three goes to the Director General of the NIHB program. You get the decision in writing at every level.

Children: Jordan's Principle and the Inuit Child First Initiative

These are separate from the health benefits above, and they are broader. They can cover health, social and educational needs — things like therapy, medical equipment, tutoring, assistive technology, assessments and mental health support.

Jordan's Principle is for First Nations children. The Inuit Child First Initiative is for Inuit children recognised by an Inuit land claim organisation, up to the age of majority — 19 in BC.

Both use the same national call centre, and there is no fee:

A few things worth knowing:

• Do not rule your child out. Phone and ask. Service coordinators and regional focal points will help you put a request together, free.
• Say if it is urgent. Requests are treated as urgent in situations such as risk to life, risk of suicide, family violence, or a child going without basic necessities. This is not an emergency service, though — in an emergency call 911.
• For an Inuit Child First request you will normally need proof that the child is enrolled with an Inuit land claim organisation, the application form, and a support letter from a health or education professional or an Elder explaining what the child needs.
• Decisions come in writing, and you can appeal within one year. For the Inuit Child First Initiative, Canada aims to review appeals within 30 business days.
• BCANDS runs a Jordan's Principle service and can do this with you: 250-381-7303.

Status card and Indian Register problems

Because these benefits run off registration, a card problem becomes a health problem fast. Common ones:

• An expired card. Registration itself does not expire — the card does. Renew it, and in the meantime ask FNHA whether your registration number is enough while you wait.
• A lost card. You can apply for a replacement.
• Never registered. Some people are entitled to register and never applied, or applied years ago and were refused under rules that have since changed.

That last point matters right now. Indigenous Services Canada says registration rules are being changed to deal with old inequities, through Bill S-2 and through a Supreme Court decision, Nicholas v. Attorney General, which Canada is applying from 13 June 2026. It affects registration for people with British Columbia connections and family histories of enfranchisement. If you or a parent or grandparent were ever refused, it is worth asking again.

Do not try to work through the Indian Act on your own. Ask one of these instead:

• Victoria Native Friendship Centre reception — 250-384-3211. They will point you to the right worker.
• BCANDS — 250-381-7303.
• Your Nation's membership or band office, if you have one you can call.

Métis people in BC

Being clear about this saves people a wasted trip. The federal eligibility rules for Non-Insured Health Benefits name registered First Nations people and recognised Inuit. They do not name Métis people, and the FNHA program in BC is for people with status. So the dental, vision and transportation benefits on this page are, as the rules currently stand, not available to Métis citizens.

That does not leave you with nothing. In BC:

• Métis Nation BC (MNBC) has a Ministry of Health with programs for citizens — including an Elders assistance program, health navigation through the Métis Health Experience Program, and supports for people living with cancer or diabetes. Ministry of Health: 604-557-5851.
• The Métis Crisis Line is open for Métis people in BC: 1-833-638-4722.
• MNBC citizenship is what unlocks most MNBC programs. If you are not a citizen yet, start at mnbc.ca or email citizenship@mnbc.ca.
• BCANDS serves Indigenous people with disabilities regardless of status, including Métis people. 250-381-7303.
• The Victoria Native Friendship Centre serves First Nations, Métis and Inuit people in Greater Victoria, with or without status. 250-384-3211.
• And every mainstream benefit still applies — the Disability Tax Credit, PWD, the Canada Disability Benefit, the dental and drug programs.

This does not replace your other benefits

People sometimes assume that being covered by FNHA means they cannot claim anything else. That is wrong, and it costs real money.

You can have FNHA health benefits and:

• The Disability Tax Credit — a tax credit, nothing to do with health coverage. It is also the door to the next two.
• The Canada Disability Benefit — a monthly federal payment.
• The RDSP — up to $1,000 a year paid into a savings plan, with no deposit from you.
• PWD, BC's disability assistance — a monthly provincial payment. BCANDS helps people apply for it.

None of these ask whether you have status. None of them are reduced because FNHA pays your dentist.

Why people miss this

• They have a status card and assume that is enough. In BC you have to enrol with FNHA. One phone call.
• They were refused once at a counter by staff who had never billed the program, and never went back.
• They were told to phone the federal NIHB program, got nowhere, and gave up. In BC it is FNHA.
• They paid first and asked later, and lost the money because the item needed prior approval.
• Nobody told them medical transportation existed, so they paid for the ferry and the hotel themselves.
• They think claiming this cancels PWD or the Canada Disability Benefit. It does not.
• Their card expired and they thought their coverage had ended with it.

Where to get help in Victoria

Reachable is not an Indigenous organisation. The people below are, and they do this work every day — start with them.

• Indigenous Disability Canada / BCANDS, Victoria — disability case management, help applying for PWD and the Monthly Nutritional Supplement, RDSP navigation, and Jordan's Principle. 250-381-7303 or toll-free 1-888-815-5511. Email bcands@bcands.bc.ca.
• Victoria Native Friendship Centre, 231 Regina Avenue — reception 250-384-3211, Monday to Friday 8:30 am to 4:30 pm. Their Primary Care Clinic is at 209–2951 Tillicum Road, 250-940-2669, Monday to Friday 9:30 am to 3:00 pm. Status is not required to be served.
• Métis Nation BC Ministry of Health — 604-557-5851. Métis Crisis Line 1-833-638-4722.
• Jordan's Principle and Inuit Child First Initiative — 1-855-572-4453, 24 hours a day.
• 211 — dial 211 any time for other options near you.

Or call the Reachable Line and we will look it up with you, out loud, at your pace, and give you the number to call next.

Related guides

• Dental care and prescription costs — what is there for everyone in BC, including people this program does not cover.
• The Disability Tax Credit — separate from health coverage, and it unlocks several other benefits.
• Getting the PWD designation — BC's disability assistance. BCANDS helps people apply.
• The Canada Disability Benefit — a monthly payment that needs the Disability Tax Credit first.
• Who to call in Victoria — the short list of numbers worth keeping.
• All guides — the full library.

Where this comes from

Everything on this page comes from a program's own page, read on the date shown. Rules and covered items change. If you are reading this long after the date at the top, phone the number instead of trusting the page.

• Indigenous Services Canada, Non-insured health benefits for First Nations and Inuit: sac-isc.gc.ca — NIHB (read 3 September 2026)
• Indigenous Services Canada, Who is eligible for the NIHB program: sac-isc.gc.ca — NIHB eligibility (read 3 September 2026)
• Indigenous Services Canada, Contact the Non-Insured Health Benefits program: sac-isc.gc.ca — NIHB contact (read 3 September 2026)
• Indigenous Services Canada, Appealing a decision under the NIHB program: sac-isc.gc.ca — NIHB appeals (read 3 September 2026)
• First Nations Health Authority, Health Benefits: fnha.ca/benefits (read 3 September 2026)
• First Nations Health Authority, Eligibility: fnha.ca — eligibility (read 3 September 2026)
• First Nations Health Authority, Pharmacy benefits (PharmaCare Plan W): fnha.ca — pharmacy (read 3 September 2026)
• First Nations Health Authority, Appeals: fnha.ca — appeals (read 3 September 2026)
• Indigenous Services Canada, Jordan's Principle: sac-isc.gc.ca — Jordan's Principle (read 3 September 2026)
• Indigenous Services Canada, Inuit Child First Initiative: sac-isc.gc.ca — Inuit Child First Initiative (read 3 September 2026)
• Indigenous Services Canada, Indian status: sac-isc.gc.ca — Indian status (read 3 September 2026)
• Indigenous Disability Canada / BC Aboriginal Network on Disability Society: bcands.bc.ca (read 3 September 2026)
• Métis Nation BC Ministry of Health: health.mnbc.ca (read 3 September 2026)
• Métis Nation BC, Health: mnbc.ca — health (read 3 September 2026)
• Victoria Native Friendship Centre: vnfc.ca (read 1 September 2026)

Reachable is not an Indigenous organisation, a health authority, or the government. This guide explains public programs in plain language so you can go and claim them, and points you to the Indigenous-led organisations who can act on your behalf. It is not advice about your own health or your own file.