Manitoba Health Plan
Manitoba Health Plan: Summary of Benefits
Manitoba’s provincial health plan is known as Manitoba Health, Seniors and Active Living, and the provincial drug benefits program is known as Pharmacare. These benefits are available to all permanent residents of Manitoba who reside in the province for a minimum of 6 months a year.
Coverage Summary
Services Covered by Manitoba Health Plan
Physician services that are medically required.
Surgery and anaesthesia.
X-ray and laboratory services when ordered by a physician and performed in an approved facility.
One routine eye exam by an optometrist every 2 years for residents under 19 or over 64 years old.
Eye exams that are considered medically necessary by a physician or optometrist are covered regardless of age.
Up to 7 chiropractor visits per calendar year. Spinal column, pelvis and extremities adjustments all covered.
Some dental procedures are covered when performed in a hospital.
Emergency ambulance services are usually not covered by Manitoba Health. Exceptions are some air ambulance transfers and land transfers between medical facilities.
Services Not Covered by Manitoba Health Plan
Health services requested by a 3rd party (e.g. exams and lab tests for employment, driver’s licenses, etc.).
Most prescription drugs, unless given in a hospital and medically necessary, or unless you qualify for Pharmacare.
Ambulance transportation costs, unless being transported between medical facilities. Note that there is a Northern Patient Transportation Program available for residents who live north of the 53rd parallel).
Private and semi-private hospital rooms.
Chiropodists, podiatrists and acupuncturists.
Psychologists and dietitians (unless service is performed in a hospital).
Private nursing.
Any procedure or service not medically required (e.g. cosmetic surgery).
All chiropractic services that are not considered adjustments.
Personal home care received out of province.
Extra costs associated with private and semi-private hospital rooms.
Advice rendered over the telephone.
Routine eye exams are not covered if you are aged 19 to 64.
Any chiropractic services required as a result of an automobile accident if covered by Manitoba Public Insurance.
Personal Home Care
Standard (not semi-private or private) accommodations.
Basic nursing.
Assistance with daily living activities.
Physiotherapy plus occupational therapy.
Medical and surgical supplies if medically required.
Prescription drugs that are approved by Manitoba Health.
Meals (this includes required specialty diets).
Laundry and linen services.
Residents who have always resided in Manitoba are eligible for personal home care benefits; newcomers are eligible after residing in the province for 24 consecutive months. An assessment panel must determine that you require personal home care in order to receive insured benefits.
Hospital Services
Standard accommodations and meals.
Nursing services that are medically necessary.
Laboratory, x-ray and diagnostic procedures.
All medications that are given in a hospital.
Operating room, anaesthetics and all surgical supplies.
Occupational therapy, physiotherapy and speech therapy services.
Dietetic (diet and nutrition) counseling.
Pharmacare
Pharmacare is a drug benefit program for Manitobans who cannot afford high prescription drug costs. It is based on total family income and the amount paid for eligible prescription medications; a deductible is determined by family income. To qualify a person must:
Paid for eligible prescription medications; a deductible is determined by family income.
Be eligible for Manitoba health coverage.
Not have prescriptions paid for by any other federal and/or provincial program.
A prescription drug is eligible for coverage if it is listed in the Pharmacare Drug Benefits Formulary. For further information, see the Manitoba government’s Pharmacare web page.
