Manitoba Health

Manitoba Health

Questions and Answers about Health Care Coverage

This page outlines benefits administered by the Insured Benefits Branch of Manitoba Health and also provides

information on eligibility and registration. Please click on any of the questions below:

Eligibility

• Am I eligible for coverage?

• I'm new to Manitoba. How do I apply for coverage?

• I'm new to Canada. How do I apply for coverage?

• I lost my Manitoba Health Card. How do I replace it?

Hospital/Medical Coverage in Manitoba

• What medical services are insured by Manitoba Health?

• Which hospital services are insured?

• What insured benefits are available to personal care home residents?

• What health services are not insured?

• If I need an ambulance, is it covered by Manitoba Health?

• Am I eligible for the Northern Patient Transportation Program?

Moving (Temporarily or Permanently)

• I'm moving away from Manitoba. Is my health care still covered?

Out of Country Referrals

• What if I require medical care that is not available in Manitoba or Canada?

Emergency Care or Medical Attention Outside of Manitoba or Canada

• What if I have to see a doctor while in another province?

• Am I covered for emergency care outside of Canada?

Student Information

• I’m a student. What do I have to do to maintain Manitoba Health coverage if I study in another province or

country?

Am I eligible for coverage?

To be eligible for Manitoba Health coverage you must:

• Be a Canadian citizen or have Immigration status as outlined in The Health Services Insurance Act

• Establish a permanent residence in Manitoba, and

• Reside (physically) in Manitoba six months in a calendar year

The following are not eligible for coverage:

• tourists

• transients

• visitors

• students other than Manitoba residents

• Students temporarily absent from other countries or other provinces and territories in Canada to attend

educational institutions in Manitoba are not eligible for registration with the Manitoba Health Plan.

I'm new to Manitoba. How do I apply for coverage?

If you are eligible (i.e., legally entitled to be in Canada and live in Manitoba for at least 183 days of the year),

coverage will begin on the first day of the third month after your arrival in Manitoba. For example, if you arrive on

April 29, April will count as the first month, with May and June as the following two. Therefore, in this case your

coverage would begin July 1.

When you register, Manitoba Health requires your Social Insurance Number, previous health card, birth certificate

and/or driver’s license. Until your health coverage begins you should maintain your coverage with your previous

health plan.

Please report changes such as a new address, birth, adoption, death, marriage, divorce, or legal separation to the

Insured Benefits Branch. Documentation is required for some changes.

Where can I register for Manitoba Health coverage?

Client Service Centre

Manitoba Health

300 Carlton Street

Winnipeg, Manitoba R3B 3M9

For more information call: (204) 786-7101

Fax: (204) 783-2171

Toll free: 1-800-392-1207

TDD/TTY: (204) 774-8618

TDD/TTY Relay Service outside Winnipeg: 711 or 1-800-855-0511

or

City of Winnipeg

510 Main Street

Winnipeg, MB R3B 1B9

or

Rural areas: Contact the city or municipal office in your area. For more information, call toll-free 1-800-392-1207.

For TTY/TDD, call 711 or 1-800-855-0511.

Remember: It is an offence to allow anyone, other than those listed on your registration certificate, to use your

certificate.

I'm new to Canada. How do I apply for coverage?

If you are a new resident and would like to apply for Manitoba Health coverage, please present your passport and

all other original Citizenship and Immigration Canada documents which have been issued to you and your

dependants. Providing the document you have been issued is acceptable as outlined in The Health Services

Insurance Act, you may be eligible for coverage.

Who is eligible for Manitoba Health coverage?

Returning Canadians

You are eligible for coverage the day you arrive in Manitoba, when proof of your Canadian citizenship and

residence status are provided.

Permanent Resident

You are eligible for coverage on your date of arrival in Manitoba or the date permanent residence is granted.

Work Permit

If your Work Permit is valid for at least 12 months in Manitoba, you and any family members listed on the Work

Permit, are eligible for coverage as of the date it was issued. If your Work Permit is less than 12 months, you are

not eligible until you receive an extension allowing you to stay in Manitoba for at least 12 months. You will then be

covered as of the date of extension.

Visitor/Student Record

You are not eligible for coverage unless you are accompanying a spouse or parent who has a Work Permit valid

for 12 months or more. The Visitor/Student Record must be valid for at least 183 days. Dependants who reach

the age of 18 must be attending a recognized educational institution or have a Work Permit to be eligible for further

benefits.

Where can I register for Manitoba Health coverage?


Manitoba Health

300 Carlton Street



Fax: (204) 783-2171

Toll free: 1-800-392-1207

TDD/TTY: (204) 774-8618


or

City of Winnipeg

510 Main Street

Winnipeg, MB R3B 1B9

or

Rural areas: Contact the city or municipal office in your area. For more information, call toll-free 1-800-392-

1207. For TTY/TDD, call 711 or 1-800-855-0511.

I lost my Manitoba Health Card. How do I replace it?

If your Manitoba Health card is lost, stolen, or damaged, please contact the Insured Benefits Branch immediately

for replacement.

What medical services are insured by Manitoba Health?

Manitoba Health directly pays physicians’ services that are medically required for you or your dependants. If you

are a Manitoba resident, and are physically present in the province for 183 days, you are eligible for insured

medical services. Benefits include the following services:

• Patients who are billed for insured services by physicians who practice outside the plan are entitled to

reimbursement from Manitoba Health

• Physicians’ services

• Surgery / anaesthesia

• X-ray and laboratory services in approved facilities when ordered by a physician

What other practitioners’ services am I insured for?

Optometrists

If you are under 19 years of age or 65 and over you may receive one complete routine eye exam every two years.

Exams for all ages will be covered if deemed medically necessary by your physician or optometrist.

Chiropractors

Manitoba Health will insure a maximum of 12 visits per Manitoba resident per calendar year. The adjustment of

the spinal column, pelvis and extremities are insured chiropractic services.

Dental Surgeons

Manitoba Health will insure certain dental procedures when hospitalization is required.

Which hospital services are insured?

You are insured for the following hospital services:

• Accommodation and meals at the standard level

• Necessary nursing services

• Laboratory, x-ray and diagnostic procedures

• Medications administered in a hospital

• Use of the operating room, care room and anaesthetic facilities

• Routine surgical supplies

• Occupational, speech and physiotherapy

• Dietetic counselling

What insured benefits are available to personal care home residents?

If you have always lived in Manitoba, you are eligible for personal care home benefits. If you are a newcomer to

Manitoba you are eligible after living in the province for 24 consecutive months.

If you formerly lived in Manitoba for 30 years or more you are eligible on the date you return to Manitoba as a

permanent resident, after an absence of less than 10 years. The waiting period requirement does not apply to a

person who has been a resident of a province or territory of Canada for five consecutive years and immediately

establishes himself or herself as a resident of Manitoba. The need for placement in a Manitoba personal care

home is determined by an assessment panel authorized by Manitoba Health.

If a Manitoba assessment panel determines that you require care in a personal care home and you meet the

residency requirements, you may receive insured benefits.

Some of these benefits include:

• standard accommodation

• basic nursing care

• assistance with and/or supervision of the activities of daily living

• physiotherapy and occupational therapy

• medical and surgical supplies

• prescribed drugs and related preparations approved by Manitoba Health

• meals including special diets

• laundry and linen services

For more information on any of the above programs contact:


Manitoba Health

300 Carlton Street



Fax: (204) 783-2171

Toll free: 1-800-392-1207

TDD/TTY: (204) 774-8618


Everyone who lives in a Manitoba Personal care home is required to pay a daily residential fee established by

Manitoba Health. For details write or telephone:

Residential Charge Program

Financial Services

Manitoba Health

300 Carlton St.

Winnipeg MB R3B 3M9

Telephone: (204) 786-7150

What health services are not insured?

Services not insured include the following:

• personal care home benefits outside of Manitoba

• health services performed at the request of a third party, such as examinations for employment, drivers'

licences, insurance, travel, immigration or emigration

• care and treatment covered by the Workers' Compensation Board, the Department of Veterans' Services

or by other statute

• services that are not medically required

• preparation of records, reports, certificates or communications, or testimony in a court

• drugs, medications, vaccines, sera or biological products, materials and surgical supplies, except as

provided for under the regulations

• ambulance and transportation subsidies except as listed in the regulations

• private nursing

• additional charges for a private or semi-private room

• television and radio-telephone services

• services performed by psychologists and dietitians outside a hospital or institution

• services performed by chiropodists and podiatrists

• services performed by audiologists, speech therapists, occupational therapists and physiotherapists in

private practice

• chiropractic services other than adjustments

• acupuncture

• telephone advice

• services provided by any other practitioner in the healing arts except as listed in the regulations

• Effective April 1, 1996 routine complete eye examinations for persons 19 years of age or older but under

the age of 65

• Effective August 1, 1996 chiropractic treatments as a result of a motor vehicle accident covered by

Manitoba Public Insurance

• services such as examinations, laboratory tests, x-rays and other procedures related to uninsured

services

If I need an ambulance, is it covered by Manitoba Health?

Manitoba Health will cover medically-necessary, land ambulance inter-facility transports when patient is being

transported between designated health-care facilities for diagnostic tests or treatment, or from a more specialized

level of care to another facility closer to home for rehabilitation or recovery.

Eligibility criteria for coverage of inter-facility medical transports includes:

• the patient must be a resident of Manitoba with a valid Manitoba Health card,

• the patient must medically require transportation by ambulance as determined by a physician, and

• the patient is being transferred between designated health-care facilities for diagnostic tests or treatment,

or from a more specialized level of care to another facility closer to home for rehabilitation or recovery.

Consistent with practices in many other provinces, patients will still be responsible for emergency ambulance

transportation costs. These costs may be covered by other insurance coverage. First- or third-party insurers will

continue to cover these services for their clients. Examples of first- or third-party insurers include the Royal

Canadian Mounted Police, National Defence, the Worker's Compensation Board and Manitoba Public Insurance.

Out of Province Transport of Manitobans

If you require an ambulance while out of the Province there are no subsidies/coverage from the Manitoba

government. You will be charged by the ambulance service/company that provides the service at full cost

recovery. The rate for out of province ambulance service may be substantially higher than rates charged local

residents, as local subsidies will not apply.

A Manitoba ambulance may transport you if you require routine medical care in a bordering province to a

neighbouring provincial facility. Ambulance costs would be billed at local Manitoba rates.

Manitoba Physicians in border areas should be aware that referrals to neighbouring provinces may have significant

financial consequences to you, the patient. Should the physician in the bordering hospital elect to refer you for

specialized care within that province, you would be subject to the full cost recovery fee charged by that Province at

a non-resident rate for transport. Transportation costs from out of province hospitals are not an insured

service.

Air Ambulance Transfers

Air ambulance transfers may be an insured service in one of three ways:

1. Patients meeting the acuity requirements for transportation under the Manitoba Lifeflight Air Ambulance

program are fully insured for the air component of the transport but are responsible for all costs

associated with land ambulance transport to and from the airport

2. Patients located north of the 53rd parallel qualify for the Northern Patient Transportation Program for

medically necessary transportation

3. First nation residents living on reserves may also qualify for medical air or land transportation under

federal programs

Physicians are encouraged to contact Manitoba Health Out-of-Province claims or Lifeflight prior to referring any

patient to an out of province hospital.

Am I eligible for the Northern Patient Transportation Program?

You may be eligible for northern transportation subsidy to help pay for transportation costs if you live north of the

53rd parallel in Manitoba and are required to travel long distances for specialty medical care.

For more information about the Northern Patient Transportation Program, please click here.

I'm moving away from Manitoba. Is my health care still covered?

Moving from Manitoba permanently:

If you are leaving Manitoba permanently, you should apply to the Insured Benefits Branch for an Out-of-Province

Certificate. You will be eligible for coverage:

• If you are moving to another province or territory

Coverage by the Manitoba Plan is provided for the remainder of the month in which you arrive at your

new residence plus two additional months (except personal care home benefits). Immediately on arrival

be sure to contact the health insurance plan in the new province of residence to arrange for continuity of

coverage.

• If you are moving to another country

Coverage by the Manitoba Plan is provided for the remainder of the month in which you leave Manitoba,

plus two additional months.

If you are a student leaving Manitoba to study, please click here.

Moving for a temporary employment opportunity:

If you are employed outside of Canada with plans to return, you must provide Manitoba Health with a copy of your

work contract that indicates the length of your work term. If you intend to return to Manitoba, Manitoba Health may

extend your coverage for up to 24 months.

Note: If you plan on taking your spouse or children with you, please inform Manitoba Health to ensure their

continued coverage.

Taking a vacation, or an extended leave, but plan on returning:

To remain eligible for Manitoba Health coverage, you must be present in Manitoba for at least 183 days of the

calendar year, which do not have to be consecutive. In this event, apply for a term certificate. If you plan to be

away for longer than 90 days, please contact Manitoba Health for more information.

If you are planning on moving, either temporarily or permanently, and wish to apply for continued health

coverage, please contact Manitoba Health at:

Registration

Manitoba Health

300 Carlton Street

Winnipeg, MB R3B 3M9


Toll free: 1-800-392-1207

FAX: (204) 783-2171

TTY/TDD: (204) 774-8618


Please note: We recommend you explore private insurance options along with your Manitoba Health coverage.

What if I have to see a doctor while in another province?

Manitoba has agreements with all Canadian provinces (except Quebec) to allow physicians to bill your provincial

health plan, although some physicians may choose to bill you directly. If you are admitted to an approved hospital

anywhere in Canada, Manitoba Health will pay the standard rate. Because some services are excluded, you are

encouraged to obtain additional health insurance before travelling. Contact Manitoba Health for more information.

Note: You must show your Manitoba Health card to the doctor or hospital.

Am I covered for emergency care outside of Canada?

Doctor Bills - Manitoba Health will pay for emergency doctors’ services outside of Canada at a rate equal to what

a Manitoba doctor would receive for a similar service.

Hospital Bills - Emergency hospital care is paid on an average daily rate established by Manitoba Health.

You may be charged more than the amount paid by Manitoba Health for services provided outside Canada.

The difference above the covered amount may be substantial and is your responsibility.

Bring or mail your original bill to the Out-of-Province Claim Section at Manitoba Health within 6 months of receiving

care. If you have made payments on your bills, Manitoba Health requires a receipt showing the amount paid. If

you do not include your receipt, Manitoba Health will pay the hospital or doctor directly.

For more information contact:

Manitoba Health

300 Carlton Street

Winnipeg, MB R3B 3M9


Toll free: 1-800-392-1207 Ext. 7303

TDD/TTY: 774-8618


I’m a student. What do I have to do to maintain Manitoba Health coverage if I study in another province, territory, or country?

Any Manitoba resident who leaves the province temporarily to attend an accredited educational institution is

eligible, provided the following requirements are met.

If you are a Manitoba resident leaving the province to attend school on a full-time basis, the following letters must

be provided to Manitoba Health prior to your departure:

1. A letter from you requesting continued coverage from Manitoba Health. This letter should contain your

full name, permanent Manitoba address and temporary new address, the date of departure and expected

date of return to Manitoba, Manitoba Health number, and the names of any family members

accompanying you.

2. A letter from an accredited educational institution confirming your full-time attendance and duration of

studies. You must reapply for coverage and provide confirmation for each subsequent year.

After these letters are received, a term certificate confirming your eligibility during your absence will be sent to you.

Where can I send/drop off my materials?

Manitoba Health

300 Carlton Street



FAX: (204) 783-2171

Toll free: 1-800-392-1207

TDD: (204) 774-8618


What happens if I need to see a doctor or receive medical attention?

In Canada:

Show your Manitoba Health card to the physician. The physician will either bill Manitoba Health directly for the

services, or bill you, in which case you need to obtain an itemized receipt. Manitoba Health will pay you according

to that province or territory’s fee schedule rate.

Outside Canada:

Payment of the bill may be your responsibility. Submit your original receipt to Manitoba Health for consideration of

payment. You will be reimbursed according to the rate which would have been paid had the same care been

received in Manitoba.

Please note: It is recommended you obtain additional medical insurance before leaving.

The Manitoba Health Services Insurance Plan is financed from general revenues of the Province of Manitoba and

with funds provided by the Government of Canada. All statements are subject to the provisions of The Health

Services Insurance Act and Regulations.

For more information:

Insured Benefits Branch Manitoba Health 300 Carlton Street

Winnipeg MB R3B 3M9 CANADA

Phone Numbers: Voice: (204) 786-7101

Toll Free: 1-800-392-1207 Fax: (204) 783-2171

Deaf Access Line TTY/TDD: (204) 774-8618

Residents within the province from outside Winnipeg: Deaf Access Line TTY/TDD:

Call the Manitoba Relay Service at 711 or 1-800-432-4444 to reach the above number.

Manitoba Pharmacare Program: Voice: (204) 786-7141

Toll-Free: 1-800-297-8099 E-mail: [email protected]

Health Care Abuse/Fraud Line: Voice: (204) 786-7118

Toll-Free: 1-866-778-7730

Is Your Question Still Not Answered? E-mail the Insured Benefits Branch

Residents should carry their registration certificate (Manitoba Health card) at all times to present when they or their dependants require health services.

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