NIHB and Métis Health Benefits for Elder Care in the NWT

Three Health Benefit Programs Serving NWT Seniors

The Northwest Territories has three parallel health benefit programs that cover services beyond what the standard territorial health plan provides. Which program your parent accesses depends on their Indigenous status:

Non-Insured Health Benefits (NIHB) — a federal program administered by Indigenous Services Canada for registered First Nations and recognized Inuit. Covers prescription drugs, dental care, vision care, medical supplies, mental health counselling, and medical transportation.

NWT Métis Health Benefit — a territorial program for Métis residents. Provides coverage comparable to NIHB, including prescriptions, medical supplies, and travel for medical care.

Extended Health Benefits (EHB) — a territorial program for non-Indigenous and Métis NWT residents aged 60 and older. Covers prescriptions, medical supplies, and medical travel.

A common source of confusion: NIHB and the NWT Métis Health Benefit are not age-restricted — they cover eligible individuals at any age. EHB, by contrast, requires the beneficiary to be 60 or older. For Indigenous seniors, NIHB or Métis Health Benefits typically provide broader coverage than EHB, so families should verify enrollment in the appropriate program rather than defaulting to the territorial one.

What These Programs Cover During Long-Term Care

When a parent enters one of the NWT's nine public long-term care facilities, clinical care and standard medications are covered by the facility's operating budget. But gaps remain — and this is where NIHB, Métis Health Benefits, and EHB fill in.

Prescription drugs beyond the formulary. Facility pharmacies stock medications on the NWT Pharmacare Formulary. If a physician prescribes a non-formulary drug, the cost falls to the resident unless their benefit program covers it. NIHB covers a broader drug list than the territorial formulary alone, which means some medications that would be out-of-pocket for non-Indigenous residents are covered for NIHB-eligible seniors.

Medical travel for specialist care. NWT long-term care facilities do not have on-site specialists for every condition. When a resident needs to travel to Yellowknife, Edmonton, or another centre for specialist appointments, medical travel benefits cover transportation, accommodation, and meals. NIHB and EHB both cover medical travel, but the administrative channels and approval processes differ.

Medical supplies and equipment. Mobility aids, hearing aids, prosthetics, and other medically necessary equipment not provided by the facility can be covered through NIHB or EHB when prescribed by a healthcare provider.

The Medical Travel Co-Payment and Who Is Exempt

Under the NWT Medical Travel Policy, patients face a mandatory $400 co-payment per trip. This applies to everyone — but several benefit programs provide exemptions:

• NIHB-enrolled seniors — the $400 co-payment does not apply. NIHB covers medical travel costs directly.
• EHB-enrolled seniors — 100% medical travel coverage, including escort expenses when approved. The $400 co-payment is waived.
• Seniors not enrolled in any supplementary program — the $400 co-payment applies and must be paid out of pocket (though it qualifies as a medical expense for tax purposes).

For families managing a parent's care from outside the territory, understanding which travel benefit program applies — and whether the non-medical escort provision covers a family member's travel — makes a meaningful financial difference.

Navigating Dual Coverage

Some NWT seniors qualify for more than one program. A Métis elder over 60, for example, could potentially access both the NWT Métis Health Benefit and EHB. In practice, the programs coordinate to avoid duplicate coverage — one serves as the primary payer and the other fills remaining gaps.

If your parent has NIHB coverage through their First Nation, that is typically the primary program. Territorial programs act as supplementary coverage. The administrative coordination happens behind the scenes at the pharmacy and medical travel office, but families should confirm enrollment in all applicable programs to ensure nothing falls through the gaps.

Income Assistance Interactions

Medical travel support provided by the territory — through any of these programs — is fully exempt from the ECE income assistance calculation. It does not count as income and does not affect subsidy eligibility for long-term care co-payments. Similarly, residential school settlements, Indian Day School settlements, and Sixties Scoop compensation are completely excluded from the means test.

The Northwest Territories Long-Term Care Costs & Subsidies Guide covers how NIHB, Métis Health Benefits, and EHB interact with the territorial long-term care system, including the specific administrative steps for coordinating medical travel and non-medical escort approvals.

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