NIHB Flashcards
eligibility (3)
eligible FN clients
-with client specific ID #
Recognized inuit clinets
-with client specific ID #
<12 month old with eligible parent/guardian
-can be extended to 24 months
do clients pay deductibles or co-paymenrts for eligible medications
no
are pharmacies reimbursed
drug cost + mark-up +dispensing fee
drug benefit list (DBL)
list all drugs (Rx and OTC) covered
open benefit
no established criteria or prior approval requirements
limited use benefits
drugs and criteria on DBL
- may = eligible if criteria met
- some req limited use req form
exception drugs
not listed in DBL
-may be approved in special circumstances with exception drug req form
LU is diff from ODB style
true
can OHIP+ and NIHB be coordinated
no
NIHB and private be coordinated?
yes
OTC items see pp
slide23-24
recommendation documentation include what
date patient name address DOB drug name and quant drug dosage amount recommended RPh sig/ID
can fees be passed to patients with NIHB coverage
no, pharmacy pay then phone NIHB drug exception centre
how many dispensing fees covered by NIHB
1 fee/28days/product/clinet
NIHB RPh reccomendation program for OTCs
full coverage for sched II, III, U items on NIHB DBL IF RECOMMENDED AND DOCUMENTED BY A RPh, regardless of Rx authority when item falls within SoP
examples of OTC
vitamins, NRT, contraception, Naloxone, epinechprine autoinjectos, spacer devices for inhalers, glucose test strips
how pharmacy providers reduce barriers
proactively engaging with eligible clients about program
