Coverage
NWT Extended Health Benefits for specified diseases covers several diseases and conditions. However, some NWT residents may have other plans that cover these diseases/conditions. Therefore, you should first claim from the other insurance company, before claiming from the Department of Health and Social Services.
Diseases/Conditions Covered
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Alcohol Dependency All Other HIV Related Diseases Alzheimer’s Disease Asthma Cancer Celiac Disease Cerebral Palsy Chronic Obstructive Lung Disease Chronic Psychosis Cleft Lip and Cleft Plate Congenital Cytomegalovirus Infection Congenital Anomalies and Chronic Disease of the Urinary System Congenital Heart Disease Crohn’s Disease Cystic Fibrosis Dermatomyositis Diabetes Insipidus Diabetes Mellitus Drug Dependency Epilepsy Head Injury |
Human Immunodeficiency Virus Infection Hypertension (subject to certain blood pressure levels) Ischemic Heart Disease Lupus Erythematosus Multiple Sclerosis Muscular Dystrophy Osteoarthritis Pernicious Anemia Phenylketonuria (PUK) Psoriasis Rheumatic Fever Rheumatoid Arthritis Rickets Scleroderma Scoliosis Spina Bifida Spinal Cord Injury Tuberculosis Ulcerative Colitis Wegener’s Granulomatosis |
Benefits/Conditions Not Covered
The following benefits/services are NOT covered by Extended Health Benefits:
- third party physicals such as insurance medicals, or physicals required for food handlers, passport or employment
- optometrists examination
- chiropractors
- naturopaths
- podiatrists
- osteopaths
- acupuncture treatments
- physiotherapy and/or psychology services received outside an approved hospital facility.
- any service to which a resident is entitled under legislation, such as Workers’ Compensation Act, Public Health Act, or other territorial or federal legislation, including treatment of veterans who are entitled to such treatments as a result of service in the Armed Forces
Other Plans
Some NWT residents may be covered for benefits that are listed on the Diseases/Conditions Covered section of this site. For example, you may qualify under a plan because you or your spouse or guardian work for an employer that provides these benefits. In a few cases, Workers Compensation or private insurance plans may provide coverage. If you qualify for these benefits under any other insurance plan, you must:
- claim from the other plan first. You will usually need to pay the bill and submit it to the plan.
- if the full cost is not covered by the other plan, complete and submit an EHB claim form for reimbursement to the Health Services Administration Office. Be sure to attach original receipts and the statement of payment from the other plan. The Department of Health and Social Services will reimburse you for the remaining expenses up to the limits of the Program.