NWT Health Care Coverage Summary
NWT Health Care Plan: Summary of Benefits
The Northwest Territories provides government health care called the NWT Health Care Plan. It is available to NWT residents, and the following is a summary of coverage and benefits.
Physician Services
Services Covered by NWT Health
Diagnosis and treatment of illness/injury as well as anesthetics when needed.
Surgery when medically necessary.
Obstetrical care (includes pre-natal and post-natal care).
Eye examinations, treatment and procedures provided by an ophthalmologist.
Some dental services ONLY if related to jaw injury or disease.
Services Not Covered by NWT Health
General examinations (e.g. physical exams) and examinations requested by third parties.
All cosmetic procedures.
Prescription drugs.
Experimental procedures.
Optometrists.
Routine dental services (e.g. cleanings, exams, extractions, fillings, etc.).
Paramedical services such as chiropractors, massage therapists, naturopaths, podiatrists, acupuncturists and osteopaths.
Any phsyiotherapy, psychology or speech therapy services done outside of a hospital.
Hospital Services
Accommodation and meals (standard ward only).
Nursing services within the hospital.
Diagnostic services, i.e. x-rays, laboratory work and interpretive services.
Prescription drugs that are administered in a hospital and have been prescribed by a doctor.
Radiotherapy treatment, occupational therapy and physiotherapy.
Detoxification services provided in an approved healthcare facility.
Use of operating room, anesthetics and medical equipment.
Services Covered by NWT Health
Services Not Covered by NWT Health
Semi-private and private rooms (standard ward coverage is applied).
Ambulance charges with the exception of inter-hospital transfers.
All cosmetic surgeries and associated charges.
Dental services unless related to jaw injury and/or disease.
Alcohol and drug rehabilitation unless prior approval is granted.
Experimental services.
Metis Health Benefits
The Northwest Territories offers supplementary health benefits for indigenous Metis residents (to be eligible for these benefits you must first successfully apply for the Métis Health Benefits program).
This program includes coverage for:
Dental services (100% coverage for eligible expenses which includes routine checkups, cleanings, scalings, orthodontics, etc.).
Vision care: eyeglasses, lenses, contact lenses (if prescribed by an ophthalmologist for certain conditions), and more. Every 2 years for eligible residents aged 18 and up, and every 12 months for residents younger than 18 years old.
Reasonable and customary charges for durable medical equipment and supplies (prior approval is required). Examples are diabetic supplies, wheelchairs, walkers, orthotics, oxygen supplies, prosthetics and pressure garments.
Prescription drugs (100% coverage for eligible expenses).
Medical travel costs incurred as a result of traveling to receive treatment that is not available in your community. For travel expenses that are related to dental services note that prior approval by Alberta Blue Cross is required.
Extended Health Benefits
NWT Health also offers extended health benefits to non-aboriginal and Metis residents for specific diseases. Coverage is for prescription drugs and medical supplies/equipment.
For more information, click here.
