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:
- A First Nations person registered under the Indian Act (Status Indian)
- An Inuit person recognized by an Inuit land claim organization
- 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:
- You pay the provider directly
- Get an official receipt with the provider's credentials
- Submit a claim to Express Scripts within 1 year of the service date
- Receive reimbursement up to the regional fee maximum
How to Access Therapy Covered by NIHB
What you need
- Your Band ID number or N number - Found on your Status Card
- Signed consent form - Your provider will have you sign this
- Prior approval (for sessions beyond the first 2 hours)
Finding an enrolled provider
To find mental health providers enrolled with NIHB:
- Visit the Express Scripts NIHB Portal
- Use our provider search tool
- Or call the NIHB Client Hotline: 1-888-441-4777
Getting prior approval
For sessions 3-22:
- Your provider submits a request to Express Scripts
- Include: diagnosis, treatment plan, and number of sessions requested
- 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:
- A diagnosis
- A treatment plan
- 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
About the authors
Anas Shakra
Co-founder and lead engineer at Promptd. Trained as a software engineer at McGill and Concordia, on a mission to make mental health care easier to access across Canada.
Viktoriya Manova
Co-founder of Promptd and PhD candidate in Counselling Psychology at McGill University. She is a published researcher at the McGill Mindfulness Research Lab, a SSHRC doctoral scholar, and has completed clinical training in both private practice and hospital settings. Her research and hands-on experience with clients shape the way Promptd approaches mental health content and provider information.
You might also like
ACT vs CBT: What's the Difference? (Visual Guide)
ACT vs CBT: how do these two evidence-based therapies compare? See a visual breakdown of what each treats, how sessions work, and when to choose ACT or CBT.
Read MoreInteractive Map: Psychology Internships, Volunteering and Work Sites in Montreal
An interactive map of public and private sites in Montreal and across Quebec where psychology and counselling students can intern, volunteer, or work under supervision.
Read MorePromptd vs alternatives: how it compares to other therapy directories in Canada
How Promptd compares to other Canadian mental health provider directories on features, price, and quality, and why users choose Promptd over the alternatives.
Read More