Akwesasne Non-Insured Health Benefits

Mission Statement

“To provide assistance to all Akwesasronon in accessing the various health services available within the Akwesasne Non-Insured Health Benefits program that enhances their quality of life and well being”

Vision Statement Department of Health

“We see future generation of Akwesasronon living in a healthy community, balanced in body, mind, and in spirit”

Program Description

The Akwesasne Non-Insured Health Benefits Program (ANIHB) is a health benefit program available to all registered Members of the Mohawks of Akwesasne. The ANIHB program has assumed responsibility to administer this program and to deliver its benefits to the members. Responsibility for authorizing and pre-authorizing service and the subsequent payment for the service are vested with the ANIHB program.

To be eligible to receive benefits under the ANIHB program the following criteria is as follows:

  • Be a registered member of the Mohawks of Akwesasne.
  • A resident of one the three districts of Akwesasne, which include Kanatakon, Tsi Snaihne, and Kawehnoke, or reside in Canada and are
  • Enrolled in a provincial health insurance program such as Ontario Health Insurance Plan (OHIP), or Regie De La Assurance Maladie Deu Quebec (RAMQ) or insurance for the province in which you reside in Canada.

Eligibility Exception:

Students:

  • Students studying out of country must provide written confirmation of their registration or enrollment in a program of study from the host organization/school and such letter should document their temporary status outside of Canada.
  • A school health plan must be purchased, ANIHB will cover the cost of insurance privately acquired such Blue Cross or purchased through a Bank.

Transients Workers:

  • Transient workers (i.e. Ironworkers) are those individuals who consider Akwesasne their home base but who live elsewhere on a temporary basis for extended periods of time.

Exclusion to Benefits:

Confinement

ANIHB coverage in not provided to any persons confined to federal, provincial or territorial institutions.

  • Out of Country Travel

Akwesasne residents eligible for ANIHB services must obtain supplementary health insurance coverage when traveling outside Canada (i.e. vacation, work). If a client chooses not to purchase additional health insurance he/she is responsible for all medical expenses not covered by their provincial health insurance plan.

The ANIHB program includes pre- authorization, approval, and payment for the following services:

Services Offered:

Dental

(Benefits are provided for all Akwesasne residents and those registered all across Canada and have met the eligibility criteria requirement)

  • Examinations
  • X-rays
  • Preventative
  • Restorative
  • Endodontics
  • Periodontics
  • Dentures
  • Orthodontics
  • Some services not covered implants, bonded bridges, cosmetic procedures, charges for missed appointments, full mouth reconstruction, rehabilitation cases.
Pharmacy

(Benefits are provided for Akwesasne residents and members across Canada)

  • Prescription drugs listed on the ANIHB Drug Benefit List.
  • Approved over the counter medication
  • Medication that has criteria for prior approval usage.
  • Maximum quantity usage for narcotics.
  • Items not covered under the ANIHB program include Dietary Supplements, Household Products, Fertility Drugs, Hair Growth Stimulants
Vision

(Services are provided for the province of Ontario only)

  • Eye exams one every two years for over the age of 18.
  • Eye exams one per year under the age of 18.
  • Eyeglasses & Repairs
  • Items not covered under the vision include: lost eyewear, contact lenses has specific criteria to be eligible, progressive lenses, tints

Medical Supplies & Equipment

(Many items listed have specific criteria and eligibility requirements; please inquire within the program to ensure that you meet the criteria.)

  • Hearing Aids
  • Medical Supplies (ostomy, dressing etc.)
  • Orthotics and custom footwear
  • Oxygen
  • Respiratory Therapy
  • Wheelchairs
  • Prosthetics
Medical Transportation Program
  • Local travel is not a benefit (within 25 miles)
  • Transportation is provided to medical necessary appointments only.
  • Transportation for a resident of adult care facilities/homes for the aged.
  • Applications require prior approval 2 weeks in advance.
  • To be eligible as a driver you must provide your license, registration, insurance and provide a drivers abstract provided from the Akwesasne Mohawk Police Department.
Co-Payment Services
  • Payment provided for doctors that do not accept Quebec health as primary source of payment.
  • Also covers some services that are not covered under your provincial health card such as emergency services, canes, crutches etc..
  • Provides limited coverage for Allied Health Services such as Physiotherapy/Chiropractor

How to Obtain Services

All service requests are made through the Kanonhkwatsher:io Reception Desk, at 613-575-2341, your calls will then be transferred to a Benefit Analyst for your assistance. Should you require the assistance of the Program Manager,  Melanie Gibson, ext. 3340

Information Pamphlets about the ANIHB program.

  • For more detailed information regarding each of the programs that have been briefly described please contact the ANIHB office and we will gladly provide you with a more detailed information pamphlet.

Contact Information

Akwesasne Non-Insured Health Benefits Program
P.O. Box 941
Cornwall, Ontario
K6H 5V1
Phone#: 613-575-2341 Ex. 3340
Fax#: 613-575-1153
Toll Free Number : 1-888-514-1966

Should you require any further information please do not hesitate to contact the program at any time.