How does health insurance work in New Brunswick?
If you live in Canada, you may be eligible for public health benefits that will cover certain medical services that your physician deems medically necessary. Did you know that if you are a resident of New Brunswick you are eligible for publically-funded healthcare through Medicare?
The cost of medical care has risen significantly in recent years. Fortunately in Canada, the provincial health care systems continue to cover basic medical costs. Health care in Canada is provided by the province you reside in. While a private health insurance policy will make sure you are fully covered for medical services large or small, the New Brunswick Medicare program will make sure you do not have to pay out of pocket for certain medical expenses.
Our guide will go over what the NB Medicare plan covers, eligibility, how to apply, how to get a health card and why you may still want private health insurance.
Although the NB Medicar covers a variety of services, there are unfortunately many services they do not cover. A private health insurance plan can bridge that gap and give you comprehensive health coverage.
What is New Brunswick Medicare?
New Brunswick Medicare is a provincial healthcare plan that was established for residents in 1971. It acts in accordance with the Canada Health Act to cover those eligible for certain medically necessary services.
What does NB Medicare cover?
New Brunswick Medicare will pay for certain medically necessary services that are performed by a physician. These services include:
- most medically required services provided by a physician in either a physician’s office or in an approved hospital
- certain specified surgical dental procedures provided by a dentist when the service is medically required and rendered in an approved hospital. Note that extractions and dental work are not insured services even when performed in a hospital. Then require private dental coverage.
Treating providers may either choose to bill New Brunswick Medicare or to bill you directly for an insured service.
If a physician chooses to bill you in excess of Medicare rates, they must advise you before providing the service. Additionally, you must sign a waiver form agreeing that New Brunswick Medicare will not reimburse you any amount. A private health insurance plan would cover any excess medical bills you may find yourself incurring. We highly recommend having one in place.
New Brunswick hospitals do not bill New Brunswick residents for insured hospital services. These services must be provided in an approved hospital facility and are paid for by the Government of New Brunswick.
NB Medicare will cover the following hospital services:
- Standard hospital accommodation and meals
- Necessary nursing services
- Drugs administered while in the hospital
- Operating room, delivery room and anesthetic facilities
- Laboratory, X-ray, and other diagnostic services as deemed necessary
- Therapies such as physiotherapy, occupational therapy, speech therapy and audiology;
- Routine surgical supplies
What does NB Medicare not cover?
While New Brunswick Medicare does cover a variety of medically necessary treatments and services, there are many things it will not cover. This means you would have to cover the cost either out of your own pocket or with a private health insurance plan. Some examples of services not covered are:
- Ambulance services, as well as transportation costs to and from your place of residence to obtain medical or hospital services
- Artificial insemination
- Blood taken in a doctor’s office
- Circumcision of newborns
- Medical examinations for the purpose of an annual check-up
- Dental services provided by a physician
- Drugs and medicines
- Elective plastic surgery or other services for cosmetic purposes
- Examinations, immunizations, diagnostic or other services at the request of any third party for the purposes of employment, travel, emigration or insurance
- Any vision services
- Gastric stapling or gastric bypass
- Hospital visits solely for the administration of drugs, vaccines, serums or biological products
- Immunizations which are available through Public Health clinics, unless medical reasons require that they be given by a physician
- Medications for the patient to take home from the hospital
- Services provided by: chiropractors, chiropodists, dentists (except as stated previously), massotherapists, naturopaths, opticians, optometrists, orthodontists, osteopaths, pharmacists, physiotherapists, podiatrists, psychologists or private duty nurses
This is list is not comprehensive as they may be other services that are not covered by NB Medicare. Always check that a service is covered prior to receiving it to make sure it will be covered.
It is hard to say if and when you will need a particular treatment or medical service. But when the time comes and it is not covered by your provincial healthcare plan, you could find yourself out of pocket a lot of money. This is why we highly recommend a private health care plan. Check out our comparison tool to find a plan that is right for you.
Am I eligible for NB Medicare?
If you fit into one of the following categories, you are likely eligible for NB Medicare:
- Canadian citizen that is a legal resident of New Brunswick
- International students that meet eligibility requirements
If you follow into one of the following categories, you may not be eligible for benefits:
- Military personnel
- Students from another province
- Inmates of federal penitentiaries
Please note that owning a home in the province of New Brunswick or paying New Brunswick property or income tax does not make you automatically eligible for insured services under New Brunswick Medicare.
How do I obtain my New Brunswick Medicare card?
In order to obtain an NB Medicare card, you will need to apply to obtain Medicare coverage. You will need to submit a signed Application for Registration form for eligibility consideration.
Completed forms must be mailed to Medicare directly to:
P. O. Box 5100
Alternatively, you may deliver it in-person to a Service New Brunswick office.
Please note that a separate application for registration must be completed for any child nineteen years of age or older.
Proof of Canadian citizenship or a copy of all Canadian Immigration identification records and entry stamps on passports must accompany your request as well as proof of identity and proof of residency. Some examples of proof of identification and residency are but are not limited to:
Proof of Identity
- Birth Certificate
- Citizenship Card
- Indian Status Card
Proof of Residency
- Mortgage Document
- Rental or Lease Agreement (must be signed by landlord & tenant)
- Utility Bill - not older than 2 months (phone, energy, cable/satellite, water/sewer)
- Employment Confirmation - current (pay stub or letter from employer on company letterhead)
- Insurance Policy (home, tenant, auto)
- Valid NB Motor Vehicle Registration
- Valid NB Driver's License
Remember not to send original documents. You should send a clear photocopy instead of an original document.
Once your application is received, it will be assessed on an individual basis and other documents may be requested to verify eligibility.
Once a completed application form is received and eligibility is established, you will receive a letter indicating the start date of your New Brunswick Medicare coverage and a New Brunswick Medicare card.
How do I renew my NB Medicare Card?
Your NB Medicare card will need to be renewed every five years.
Your Medicare card will be automatically renewed and mailed to your address on file with NB Medicare. If your address changes prior to renewal, you will need to call Service New Brunswick at 1-888-762-8600 or complete a Change Request, Replacement and/or Renewal form. All household members affected by the move must be indicated on the form. If you fail to notify New Brunswick Medicare of your address changes your Medicare coverage could be terminated leaving you without any coverage.
What is the NB Medicare phone number?
If you need to contact NB Medicare, you can do so a few ways. Always make sure you have your Medicare number when contacting NB Medicare.
If you have questions related to eligibility or claims, you can contact a representative either by phone or email:
Email: [email protected]
A representative will be able to assist you Monday through Friday from 8:00 AM to 7:30 PM and Saturdays from 9:00 AM to 1:00 PM.
If you need to contact Client Advocate Services you can do so by calling (506) 453-4227 or emailing [email protected].