New Brunswick Medicare
New Brunswick Medicare: Summary of Benefits
The following information is intended as a brief summary of the New Brunswick Medicare provincial healthcare plan.
Medicare is available to permanent New Brunswick residents who reside in the province at least 6 months out of the year
Coverage Summary
Services Covered by New Brunswick Medicare
Most medical services provided by a physician in a physician’s office or in a hospital if medically required.
Certain dental procedures performed by a dentist when the service is medically required and performed in a hospital (extractions and dental work are not insured when performed in a hospital, however the anesthesia may be covered in some circumstances).
Note that medical practitioners have the option of billing either Medicare or billing you directly.
Standard hospital room and meals.
Required nursing services.
Drugs administered (while in a hospital).
Routine surgical supplies administered in a hospital.
Diagnostic services such as X-rays and other laboratory services.
Operating room, anesthetic facilities and delivery room services.
Therapies while in a hospital i.e. physiotherapy, speech therapy, audiology and occupational therapy.
Radiotherapy.
Services Not Covered by New Brunswick Medicare
Ambulance services.
Annual checkups.
Routine dental services and dentures (e.g. examinations, fillings, cleanings and extractions). Note that medically necessary dental procedures MAY be covered if performed by a dentist in an approved hospital.
Prescription drugs and medicines (unless you are covered by one of the specialty drug plans discussed below).
Examinations at the request of a third party (e.g. for employment, travel purposes, etc.)
Acupuncturists, orthodontists, opticians, chiropractors, chiropodists, massage therapists, podiatrists, osteopaths, naturopaths, physiotherapists, pharmacists, psychologists, optometrists and private nursing.
Eye glasses, frames, eye examinations and contact lenses.
Any cosmetic surgery.
Artificial insemination.
Durable medical equipment such as walkers, special crutches, and prosthetic devices such as artificial limbs, etc.
Removal of minor skin lesions (e.g. warts), UNLESS cancer is suspected as the cause.
Services deemed by the province as “experimental” or part of “applied research”.
Physician advice or prescriptions renewed by telephone.
Dental services provided by a physician.
Stomach stapling (gastric stapling or bypass).
Immunizations that you can get via Public Health clinics, unless medically necessary and done by a physician.
The difference in cost between semi-private/private hospital rooms as compared to the cost of a standard ward.
Artificial insemination.
Breast enlargement.
Circumcision.
Otoplasty if older than 18.
Vasectomy and tubal ligation reversals.
Drug Programs
New Brunswick Drug Plan
This drug plan is designed for residents who do not have prescription drug coverage via a private health insurance plan.
There are premiums for residents enrolled in the plan that are based on your family’s annual income. To be eligible you need to be covered by Medicare. Premiums range from $16.67/month to $166.67/month
Coverage is determined by the New Brunswick Drug Plan Formulary.
New Brunswick Drugs for Rare Diseases Plan
Coverage for some prescription drugs for Manitoba residents who have a specific rare disease.
Click here for a listing of these rare diseases and medications that are covered.
New Brunswick Prescription Drug Plan
Medicare does not cover prescription drugs; however, there is coverage available for residents who require assistance paying for their medications and meet the eligibility requirements by being in one of the eligibility groups listed below.
Valid beneficiary groups are:
Seniors (age 65 or older).
Residents of licenced nursing home facilities.
Social development clients.
Special needs children, and children who have been placed in the care of the Ministry of Social Development.
Residents with multiple sclerosis (certain treatment drugs are covered).
Residents with cystic fibrosis (certain treatment drugs are covered).
Recipient of a solid organ or bone marrow transplant (certain anti-rejection drugs are covered).
Certain human growth hormone drugs.
Drug coverage for residents with HIV/AIDS (must be registered by a New Brunswick infectious disease specialist).
Adults who are in a licensed, residential facility.
Prescription Monitoring Program and Drug Information System
eHealthNB, via the Electronic Health Record (or EHR) and Drug Information System (DIS), shows a patient’s medication history for prescribed medications that have been filled by a New Brunswick community pharmacy.
