NIHB

Question 1

eligibility (3)

Answer 1

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

Question 2

do clients pay deductibles or co-paymenrts for eligible medications

Answer 2

no

Question 3

are pharmacies reimbursed

Answer 3

drug cost + mark-up +dispensing fee

Question 4

drug benefit list (DBL)

Answer 4

list all drugs (Rx and OTC) covered

Question 5

open benefit

Answer 5

no established criteria or prior approval requirements

Question 6

limited use benefits

Answer 6

drugs and criteria on DBL

• may = eligible if criteria met
• some req limited use req form

Question 7

exception drugs

Answer 7

not listed in DBL

-may be approved in special circumstances with exception drug req form

Question 8

LU is diff from ODB style

Answer 8

true

Question 9

can OHIP+ and NIHB be coordinated

Answer 9

no

Question 10

NIHB and private be coordinated?

Answer 10

yes

Question 11

OTC items see pp

Answer 11

slide23-24

Question 12

recommendation documentation include what

Answer 12

date
patient name address DOB
drug name and quant
drug dosage
amount recommended
RPh sig/ID

Question 13

can fees be passed to patients with NIHB coverage

Answer 13

no, pharmacy pay then phone NIHB drug exception centre

Question 14

how many dispensing fees covered by NIHB

Answer 14

1 fee/28days/product/clinet

Question 15

NIHB RPh reccomendation program for OTCs

Answer 15

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

Question 16

examples of OTC

Answer 16

vitamins, NRT, contraception, Naloxone, epinechprine autoinjectos, spacer devices for inhalers, glucose test strips

Question 17

how pharmacy providers reduce barriers

Answer 17

proactively engaging with eligible clients about program