NIHB Mental Health Coverage: Counselling Benefits for First Nations & Inuit (2026)

If you're a First Nations or Inuit person in Canada, you may be eligible for free mental health counselling through the Non-Insured Health Benefits (NIHB) program. Administered by Indigenous Services Canada, NIHB provides coverage for a range of health services not covered by provincial or territorial health plans. As a key part of Indigenous mental health support in Canada, this program helps connect eligible individuals with Indigenous counselling services and licensed therapists at no cost.

What is NIHB (Non-Insured Health Benefits)?

NIHB (Non-Insured Health Benefits) is a federal program that provides eligible First Nations and Inuit with coverage for a range of health benefits, including:

• Mental health counselling
• Prescription drugs
• Dental care
• Vision care
• Medical supplies and equipment
• Medical transportation

Key facts about NIHB mental health benefits:

• Up to 22 hours of counselling per calendar year
• First 2 hours require no prior approval
• Direct billing available - no upfront payment needed with enrolled providers
• Coverage for both in-person and virtual sessions

Who is eligible?

You may be eligible for NIHB mental health benefits if you are:

1. A First Nations person registered under the Indian Act (Status Indian)
2. An Inuit person recognized by an Inuit land claim organization
3. A child under 2 years old whose parent is eligible

Your eligibility is typically verified using your:

• Band ID number (10-digit number on your Status Card)
• "N" number (also known as registry number)

How much does NIHB cover?

NIHB covers mental health counselling as follows:

Coverage Type	Hours	Approval Required
Initial sessions	First 2 hours	No prior approval needed
Standard coverage	Hours 3-22	Prior approval required
Extended coverage	Beyond 22 hours	Exception request needed

Important notes on coverage:

• The 22-hour limit applies per calendar year (January to December)
• Additional hours may be approved on an exception basis for those who need more support
• Session rates are covered up to the regional fee grid maximums, which vary by province
• Coverage applies to individual, family, and group counselling

NIHB Therapists and Counsellors: Who Is Covered?

NIHB covers services from licensed mental health professionals, including:

• Psychologists
• Clinical social workers / Registered social workers
• Registered psychiatric nurses
• Registered psychotherapists (Ontario and Quebec)
• Registered counselling therapists (Atlantic provinces)

In areas where legislated mental health providers are insufficient, NIHB may cover exception providers on a case-by-case basis.

Find NIHB Mental Health Providers

Direct billing vs. reimbursement

Direct billing (recommended)

Many mental health providers are enrolled with Express Scripts Canada, the company that administers NIHB benefits. With enrolled providers:

• You pay nothing upfront
• The provider bills NIHB directly
• You just need to provide your Band ID or N number and sign a consent form

Client reimbursement

If your provider is not enrolled with Express Scripts:

1. You pay the provider directly
2. Get an official receipt with the provider's credentials
3. Submit a claim to Express Scripts within 1 year of the service date
4. Receive reimbursement up to the regional fee maximum

How to Access Therapy Covered by NIHB

What you need

1. Your Band ID number or N number - Found on your Status Card
2. Signed consent form - Your provider will have you sign this
3. Prior approval (for sessions beyond the first 2 hours)

Finding an enrolled provider

To find mental health providers enrolled with NIHB:

1. Visit the Express Scripts NIHB Portal
2. Use our provider search tool
3. Or call the NIHB Client Hotline: 1-888-441-4777

Getting prior approval

For sessions 3-22:

1. Your provider submits a request to Express Scripts
2. Include: diagnosis, treatment plan, and number of sessions requested
3. Approval is typically processed within a few business days

Frequently Asked Questions

Does my therapist need to be registered with NIHB?

For direct billing, yes - providers must be enrolled with Express Scripts. However, you can still access services from non-enrolled providers and submit claims for reimbursement yourself.

Can I get more than 22 hours of NIHB counselling?

You can request additional hours through an exception process. Your provider will need to submit documentation explaining the clinical need for continued treatment. Many clients are approved for extended coverage.

Can I use NIHB with other insurance?

Yes. NIHB is a payer of last resort, meaning other insurance (employer benefits, provincial programs) should be billed first. NIHB can then cover remaining eligible costs.

What services are NOT covered?

NIHB mental health benefits do not cover:

• Services already covered by your province/territory or other insurance
• Life coaching or wellness coaching
• Services from unlicensed practitioners
• Missed appointment fees

Can I access services virtually?

Yes. NIHB covers both in-person and virtual (telephone or video) mental health counselling sessions. Virtual sessions must be provided by an eligible mental health professional.

What is the NIHB prior approval process?

For counselling sessions 3 through 22, your provider submits a prior approval request to Express Scripts Canada. The request must include:

1. A diagnosis
2. A treatment plan
3. The number of sessions requested

Approval is typically processed within a few business days. The first 2 hours of counselling require no prior approval at all.

Does NIHB cover Indigenous counselling services?

Yes. NIHB covers services from a range of licensed mental health professionals, including those who specialize in Indigenous counselling approaches. Covered providers include psychologists, clinical social workers, registered psychiatric nurses, registered psychotherapists, and registered counselling therapists. In areas where legislated mental health providers are insufficient, NIHB may cover exception providers on a case-by-case basis.

What if I'm in crisis?

If you're in immediate crisis, these resources are available 24/7:

• Hope for Wellness Help Line: 1-855-242-3310 (also offers online chat)
• National Indian Residential School Crisis Line: 1-866-925-4419
• Talk4Healing (Indigenous women): 1-855-554-4325

Contact information

• NIHB Client Hotline: 1-888-441-4777
• Express Scripts NIHB Portal: nihb-ssna.express-scripts.ca
• Indigenous Services Canada: sac-isc.gc.ca

Additional resources

• Guide to mental health counselling benefits for First Nations and Inuit
• NIHB Mental health counselling benefits
• Hope for Wellness Help Line