A Guide to New Brunswick Medicare Health Plan (MCP)
Just like Canadian citizens from other provinces, New Brunswick residents cherish the Canadian publicly funded health care plan. The Canada Health Act is the principal federal legislation which aims to ensure that every citizen in Canada has access to basic health care services. The New Brunswick government leads the way with the New Brunswick Health Plan when it comes to delivering basic health care services to its residents.
Unfortunately, New Brunswickers feel like their healthcare needs aren’t met. The provincial health has many systemic challenges and numerous gaps that prevent it from improving the health of New Brunswick residents. According to a poll conducted by the NBMS (New Brunswick Medical Society), more than 44,000 residents don’t have a family doctor. Many of them who don’t have family doctors face lengthy wait times before being able to see one.
Right now, the government is working on a new system that would provide access to primary care to patients without a nurse practitioner or family doctor. Residents without a medical provider can register with Patient Connect NB. They will be assigned a provider on a first-come, first-serve basis.
Read on to learn more about NB Medicare Health Plan, the eligibility requirements, ways to obtain a health care card, and understand why additional health and dental coverage is important. If you are a permanent resident of New Brunswick, you should know how to take advantage of the provincial healthcare benefits.
Free Healthcare Coverage in New Brunswick
New Brunswick’s provincial government health plan is called Medicare, and it is designed to provide coverage for its resident’s basic health care services. To be eligible to apply, you must be a citizen of Canada or legally entitled to remain in the country, and make the province of New Brunswick your home.
The Medicare provincial health care plan offers a handful of services and the New Brunswick government has been reducing the number of covered services each year. If you need health services that are not covered by the Medicare health plan, you are responsible for paying the bill. That could have a significant negative impact on your finances because health care costs are steadily increasing. In case of accidents or unexpected illnesses, this could have a disastrous impact on your financial security.
To get the financial protection you need, reduce your out-of-pocket expenses, and have your peace of mind, it is recommended that you opt for an additional health insurance from a private insurance company to cover medical services needed at low cost rates.
Coverage
Every New Brunswicker is entitled to universal, basic and government-funded health care. Medicare health coverage covers most medically required services such as critical illness or emergencies, while many New Brunswick employers offer additional health coverage to their employees.
Once you become a registered New Brunswick health cardholder, the NB Medicare program will pay for the following health services:
Most health services provided by a physician in a hospital (if medically required such as a critical illness) or in a physician’s office.
Certain dental procedures when the service is medically required and performed in a hospital. Dental work and extractions performed in a hospital are not covered, but in some circumstances, the anesthesia may be covered.
Medical practitioners can either bill you directly or bill Medicare.
Emergency medical services received while travelling outside Canada are covered only if pre-approved. When travelling, please consider travel insurance.
Drugs administered (while in a hospital) through the New Brunswick Drug Plan
Routine surgical supplies administered in hospitals.
Radiotherapy.
Delivery room services, anesthetic facilities, and operating room.
Therapies provided while in a hospital (e.g., occupational therapists, audiologists, speech therapists, and physiotherapists).
Substance abuse treatment (addiction to alcohol, drugs, gambling, and other).
Accidental death and dismemberment
The following medical costs are not covered by NB Medicare or hospital services:
Annual checkups.
Ambulance services.
Prescription medicines and drugs (unless covered by a certain specialty drug plan).
Routine dental services and dentures. If performed by a dentist in approved hospitals or clinics, medically necessary dental procedures may be covered.
Any cosmetic surgery.
Vision care, such as eye examinations, eye glasses, contact lenses, and frames.
Durable medical equipment (e.g., prosthetic devices, special crutches, walkers, etc.)
Drug Coverage
The New Brunswick Prescription Drug Program (NBPDP) is commonly referred to as the New Brunswick Drug Plan. It is a drug coverage plan designed to provide help with prescription drug costs to eligible New Brunswickers. All the drugs that the program covers are listed in the New Brunswick Drug Plan covered drugs Form.
The beneficiary groups of the New Brunswick Drug Plan are:
Senior citizens
Adults in special care homes
Special needs children
Children in care of the Minister of Social Development
People suffering from cystic fibrosis
People suffering from multiple sclerosis
People waiting for an organ transplant
People with growth hormone deficiency
People positive on HIV/AIDS
If you have any questions regarding the NBPDP, you may call 1-855-540-7325. The toll-information line offers bilingual services and is open Monday to Friday between 8 a.m. and 5 p.m.
Student Coverage
Canadian students get basic health benefits that are provided by the health plan of their province of permanent residence.
International students with valid student visas are eligible for NB Medicare coverage. For those awaiting or without Medicare coverage, basic health and hospital coverage is via insured plans administered by the University of New Brunswick.
International students with immigrant status qualify for Medicare benefits and have to register immediately upon arrival in the province. However, it is recommended that they get a basic personal insurance that covers dental insurance or pre-existing medical conditions that are not covered by Medicare.
Students get access to the Student Health Center if they:
are full-time students and have opted out of the UNB health insurance plan.
are Shad Valley or ELP participants.
have been accepted to STU or UNB and are enrolled in full time winter/fall classes for the upcoming semester.
When going to a health appointment, all students must bring a valid student ID card and a valid Medicare Card or Provincial Health Card. As for international students, they are required to complete a health insurance claim form each time they visit.
Registering for Medicare
New Brunswickers can register for the NB Medicare provincial plan by either visiting an office or sending their application via email. You’ll be required to present your proof of citizenship or immigration status for the application process.
If you are returning or new to New Brunswick, you can apply to obtain your health coverage by submitting a signed original Application for Registration form. Completed forms must be delivered in person or mailed to Medicare.
Applications are assessed on an individual basis. To verify your eligibility, you may be asked to provide other documents. Once your eligibility is established, you will receive a letter indicating the exact start date of your NB Medicare health coverage as well as a NB Medicare health card.
a Canadian citizen/legally entitled to stay in Canada and a resident with a principal home in the province of New Brunswick
an international student who meets all Medicare eligibility criteria
Who is not eligible for Medicare health benefits?
Inmates of federal penitentiaries
Transients
Regular members of the Canadian Armed Forces (while their family members are eligible)
Students from another province
Tourists and visitors to the province
If you’ve moved to New Brunswick from another Canadian province, you may be eligible for Medicare health coverage on the first day of the third month following the month you’ve established permanent residence in NB. For example, if you moved to NB on May 18, then May will count as the first month. In this case, your Medicare coverage would start August 1.
Coverage When Travelling in Canada and Outside of Canada
In case you require services from health professionals in any other Canadian province (except Quebec), just show your valid NB Medicare Health Card to the physician. There is an agreement with all Canadian provinces (except Quebec) thanks to which physicians can bill the NB Medicare for treatment of sickness or injury to New Brunswick residents.
Note that physicians in other provinces may bill New Brunswickers for medical services that are excluded from the agreements. In that case, reimbursement is not guaranteed.
Medicare Health Plan only covers:
Add your content...emergency hospital services, which are limited to $100 CAD per day for emergency in-patient admission and services, and $50 for out-patient emergency services;
pre-approved services; and
emergency physician services at New Brunswick rates.
In case of out-of-Canada medical services, the Medicare Health Plan only provides coverage according to rates paid by NB Medicare. The costs of medical services outside of Canada are often considerably higher, so paying the difference will be your responsibility. All travellers are strongly recommended to get additional travel from a private insurance company to cover the unexpected charges.
Applying for New Brunswick Health Card
How to Apply in Person
To start your Medicare application, you must complete an Application for Registration. Download the form here, print it, and fill it out with required information. Double check to see if you filled out everything correctly, and remember to provide your contact telephone number in case someone needs to get in touch with you directly.
For every child 19 years of age or older, you will need to fill out a separate application for registration. You must provide a copy of Power of Attorney documents if you are completing the form on behalf of an individual.
How to Apply via Mail
Besides doing it in person, you can also mail your application for registration directly via mail. Download the form, print and complete it, and be sure to provide your contact phone number. For any child 19 years of age or older, be sure to complete a separate application. Provide a copy of Power of Attorney documents if completing the form on behalf of another individual.
Remember to check whether your Canadian immigration documents are acceptable for eligibility requirements.
The completed application form, along with photocopies of all supporting documents, should be mailed to Medicare P.O. Box 5100 Fredericton, N.B. E3B 5G8.
How to Apply Online
New Brunswickers cannot apply online for their Medicare Health Card currently but we will be looking for any change and will update this article to give detailed information on how to proceed when online applications are available.
Forms and Documentation Required
When applying for Medicare, you need to bring the following documents as proof of your identity, citizenship, and residency:
For Canadian citizens:
Citizenship Card
Birth Certificate
Passport
Baptismal certificate (if place of birth is identified)
Indian Status Card
For non-Canadians:
Proof of enrollment from an approved learning institution (for international students)
Canadian Immigration Identification Records and Entry Stamp on your passport
Documents that may be accepted as proof of identity include:
Previous Provincial Health Card
Birth Certificate
Valid Passport (Canadian or foreign)
Valid New Brunswick Driver’s License
Certificate of Canadian Citizenship
Student or Employee ID Card
Legal Name Change Document
Active Temporary Resident Permit issued by Citizenship and Immigration Canada
Canadian Indian Status Card (front and back)
Valid Permanent Resident Card (front and back)
Record of Landing Document example: (Form # IMM 1000)
Baptismal Certificate (if place and date of birth indicated)
Documents that may be accepted as proof of residency include:
Property Tax Bill (current year)
Valid NB Driver's License
Valid NB Motor Vehicle Registration
Rental or Lease Agreement (must be signed by both landlord and tenant)
Insurance Policy (auto, home, tenant)
Mortgage Document
Child Tax Benefit Statement
Employment Confirmation (letter from employer on company letterhead or recent pay stub)
Utility Bill (not older than 2 months)
The same document can be used to satisfy no more than one requirement. Remember not to send original documents when applying because their return is not guaranteed.
Renewing or Replacing Your New Brunswick Health Card
Renewing Your Health Card
Upon its expiration, the New Brunswick Medicare office will automatically renew your health card and mail it to your address. Your Medicare health card is usually valid for 5 years. Check the expiry date on your Medicare card. It is valid until the last day of the month indicated.
Replacing Your Health Card
If your valid Medicare card gets lost, damaged or stolen, you should replace it. To do it, you need to visit your local Service New Brunswick office in person. The other way is to download, print and complete a Medicare Change Request, Replacement and/or Renewal form. Sign and date the document, and mail it to New Brunswick Medicare.
The Medicare card replacement fee is $10.00. Along with the completed form, you should send a money order or cheque made payable to the Minister of Finance. Those exempted from the fee are:
residents who’ve received a damaged or misprinted card;
income assistance recipients; and
seniors who receive the Guaranteed Income Supplement.
Changing the Address On Your Card
If you’ve changed your address, you need to complete and send a Change Request, Replacement and/or Renewal form or call Service New Brunswick at 1-888-762-8600. In case you fail to notify NBM of your address change, your Medicare coverage may end up terminated.
You can receive your new, valid Medicare card one month before it expires, but you have to be eligible, inform the NBM of your current address, destroy your old card, and start using the new one immediately.
Medicare Coverage Details
All permanent residents of New Brunswick have access to provincial, universal, government-funded health coverage. Keep reading to find out more about what’s covered and what isn’t covered by the NB Medicare Health Plan, as well as about extended health care, drug plan, coverage for those traveling in and out of Canada.
Dental
The NB Medicare Health Plan only covers certain surgical dental services provided in a hospital. It doesn’t cover regular dental care work and extractions.
The Health Services Dental Program is designed to help clients in the Social Development department older than 19 years of age with coverage for specific dental benefits and individuals with special needs. These benefits are those often not covered by private health insurance plans and other agencies, and are negotiated with the New Brunswick Denturists Society and the New Brunswick Dental Society.
The program doesn’t cover:
Sealants
Orthodontic services and appliances
Fluoride treatment
Oral surgeries not specified in the contract with the NB Dental Society
Root canals on posterior
Dental Costs
Those eligible for the Health Services Dental Program are entitled to a maximum of $1000 a year (excluding prosthetic and emergency services). For dentures and denture repairs, clients are usually charged up to a 10% participation fee. The participation fee may be required before dental health services are provided and is paid directly to the dental professional.
The Health Services Dental Program can’t reimburse you for dental services that you paid for yourself. There is no cost to eligible clients for other dental services, with the exception of certain types of fillings.
The New Brunswick Prescription Drug Program (NBPDP) is designed to help those who require assistance with specialty medications, with no other type of health insurance, and Seniors of 65 and older who receive the Federal GIS (Guaranteed Income Supplement). The drugs covered by the program are listed in this formulary, including drugs for treatment of:
cystic fibrosis;
multiple sclerosis;
organ transplant recipients;
growth hormone products;
HIV positive residents; and
residents covered under Family & Community Social Services
Prescription Drug costs with NBPDP
Every New Brunswicker who meets the eligibility criteria can enroll in the Drug Plan voluntarily and their premiums depend on their income. The maximum premium is $166.67 per month ($2,000 annually). Those 18 years of age and younger will not pay premiums, but one parent must enroll in the plan.
With this plan, you pay a premium (the amount is based on your yearly income and a 30 percent co-payment up to $30 per prescription.
Drugs and medicines without a Drug Plan or outside of a hospital are not covered by the NB Medicare provincial health plan.
Temporary Leave Coverage
Residents of New Brunswick must inform the NB Medicare if they are leaving the province as a result of the following circumstances:
Prior to your departure, you must inform New Brunswick Medicare by visiting their local SNB office or by calling SNB (Service New Brunswick) at 1-888-762-8600.
If leaving New Brunswick, you are advised to obtain additional insurance coverage to cover the difference that Medicare won't reimburse for.
Students & Seniors
All eligible students who are in full-time attendance at a recognized University or other educational institution outside the province or country, but normally reside in New Brunswick, receive 12-months of health coverage. They are covered only if they:
Outside Canada
maintain a New Brunswick address of permanent residence;
don’t establish permanent residence anywhere outside New Brunswick; and
provide proof annually of enrollment from the University or school they are attending.
Within Canada
maintain a New Brunswick address of permanent residence;
don’t establish permanent residence anywhere outside New Brunswick;
don’t receive health coverage in another province; and
contact New Brunswick Medicare every year.
New students that come from another Canadian province to New Brunswick and attend school are not eligible for Medicare health coverage.
International students who meet eligibility criteria are eligible to obtain a NB Medicare Health Card. International students who are not eligible for a NB Medicare card are:
students enrolled in part time studies;
exchange students;
employed graduate students employed by an approved educational institution during their studies; and
online international students studying through an institution outside of the province.
Eligible medical institutions where students can receive health care include post-secondary institutions such as community college, university, and private institutions determined by the Department of Post-Secondary Education, Training and Labor.
What Is and Isn’t Covered under New Brunswick Medicare
Dental
X-Rays and Exams
If deemed necessary in a hospital setting.
Wisdom teeth
No.
Vision
Eye Exams
No.
Glasses
No.
Laser Eye Surgery
No.
Surgery
Rhinoplasty
No.
Breast Reduction
Yes, if deemed necessary by a doctor for medical reasons and with an approval from Medicare.
Hospital
Hospital stays
Yes.
Ambulance transportation
No.
Giving birth
Yes.
Therapy and Counselling
Therapy is covered if done by a MD or a Nurse Practitioner. Counselling is not covered.
Sexual Health
Gynecologist
Yes
Erectile Dysfunction
No.
Birth Control (including IUD)
No.
Fertility Treatment
Yes, if the services associated with fertility treatment are deemed reasonable and necessary.
Specialists
Dermatologist
Yes
Physiotherapy
Yes
Massage Therapy
No
Podiatrist and Foot Care
No
Allergist and Allergy Testing
Yes
Sleep Physician and CPAP Machines
Yes
Extending NB Health Plan Coverage
New Brunswick’s provincial Medicare Health Plan provides New Brunswickers access to basic medical services at no cost. But when it comes to specific services, pre-existing medical conditions, hearing aids, disability insurance and more, the provincial health plan requires additional insurance.
We know how important it is to inform yourself before getting insured. Insurdinary is an insurance rates comparison platform where you can find out all about available health insurance plans and different options offered by Canada’s best insurance companies. Some of them offer the ability to obtain specific health coverages or customizable solutions that can meet your unique requirements.
Visit our website for more information and get a quote for extending your NB Medicare Health Plan today!
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