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Health Coverage
Covered Medical Services
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
Manitoba Health provides coverage under the provincial health plan for one routine complete eye exam provided in a two-year benefit period for patients under the age of 19 years and 65 years of age and over. All residents, regardless of age, are entitled to coverage of an eye exam when warranted by medical conditions as determined by the eye care provider. Unless the patient falls into one of these categories, eye exams are not insured. The provincial health plan also includes coverage for certain tests provided by optometrists including the Full Threshold Visual Fields Test, the Tonometry Test and the Dilated Fundus Examination.
Chiropractors
Manitoba Health will insure a maximum of seven 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.
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Covered Hospital Services
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
Dietetic counselling
Occupational, speech and physiotherapy
Health Services Not Covered
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 statutes
- 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 are covered by Manitoba Public Insurance.
- services such as examinations, laboratory tests, x-rays and other procedures related to uninsured services
Personal Care Home Coverage
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 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
What are the costs for personal care home services?
Everyone who lives in a Manitoba personal care home is required to pay a daily residential fee established by Manitoba Health.
The cost of these services is shared by the provincial government (Manitoba Health) and the client who needs the services. Manitoba Health pays the majority of the cost through the regional health authorities.
The personal care service client pays the other portion of the cost. This cost is a daily charge based on income.
As prices go up, so does the cost of looking after clients who receive personal care services. Each year, the Manitoba government reviews the residential charges to adjust for increases in income and the cost of living. As a result, charges may increase from one year to the next.
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What if I don’t meet the residency eligibility requirements for personal care home services?
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. If you are a newcomer to Manitoba, you are eligible after living in the province for 24 consecutive months. If a Manitoba assessment panel determines that you require care in a personal care home, you may be required to pay costs of $265.23 a day to cover services until your 24 month waiting period is completed.
This 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 and registers for a Manitoba health card. These individuals are only required to pay the daily charge based on income once they receive a Manitoba health card.
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I have always lived in Manitoba. Am I eligible for personal care home services?
If you have always lived in Manitoba, you are eligible for personal care home benefits.
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I'm new to Manitoba but have always lived in Canada. Am I eligible for personal care home services?
Canadian residents from another province or territory of Canada where you have lived for five consecutive years but are new to Manitoba are eligible for personal care home benefits.
To receive benefits, you must establish yourself as a resident of Manitoba and register for a Manitoba Health card. Once you receive a Manitoba Health card, you will only be required to pay the daily charge based on income.
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I’m returning to Manitoba and have been living outside of Canada for less than 10 years. Am I eligible for personal care home services?
If you formerly lived in Manitoba for 30 years or more, after an absence of less than 10 years, you are eligible for personal care benefits on the date you return to Manitoba as a permanent resident.
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I’m returning to Manitoba and have been living outside of Canada for more than 10 years. Am I eligible for personal care home services?
If you have been living outside of Canada for more than 10 years, you will be considered a newcomer to Manitoba. You will be eligible for personal care benefits after living in the province for 24 consecutive months.
If a Manitoba assessment panel determines that you require care in a personal care home, you may be required to pay costs of $265.23 a day to cover services until your 24 month waiting period is completed.
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For more information on any of the above programs contact:
Registration and Client Services
Manitoba Health
300 Carlton Street
Winnipeg, Manitoba R3B 3M9
Business hours: Monday to Friday 8:30 to 16:30
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
Residents in Manitoba personal care homes are required to pay a daily residential fee based on income 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
Ambulance Transport Coverage
Manitoba Health does not cover land ambulance transports to a hospital or health care facility. Patient costs in Manitoba are currently $250. Patients may have coverage for ambulance transport through private insurance for some or all of this cost.
Manitoba Health will cover medically-necessary land ambulance inter-facility transports when a 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 patients who:
- are residents of Manitoba with a valid Manitoba Health card,
- medically require transportation by ambulance, as determined by a physician
- are 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.
In addition, patients are not eligible for funding under the Manitoba IFT program if one of the following applies. They are:
- a member of the Canadian Forces
- a veteran of the Canadian Forces who is eligible for health care benefits from Veterans Affairs Canada
- an inmate of a Federal prison or penitentiary
- a person with a work related illness or injury and who is eligible for coverage under The Worker’s Compensation Act
- a person involved in a motor vehicle incident and who is eligible for coverage under The Manitoba Public Insurance Corporation Act
- a person who is receiving social assistance funding
- a First Nations person or an Inuit who is an eligible recipient entitled to receive benefits under the Non-Insured Health Benefits Program, Health Canada
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.
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Air Ambulance Transfers
Air ambulance transfers may be an insured service in one of three ways:
- 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.
- Patients located north of the 53rd parallel qualify for the Northern Patient Transportation Program for medically necessary transportation.
- 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.
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Northern Patient Transport
You may be eligible for a 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.
The Northern Patient Transportation Program (NPTP) subsidizes medical transportation costs for eligible Manitoba residents in the north to obtain medical or hospital care not available in their home community. Subsidies may include costs for an essential escort (ex: if required for a minor or a person with disabilities).
Program eligibility is limited to Manitoba residents who live:
- north of the 53rd parallel from the Saskatchewan boundary to the west side of Lake Winnipeg
- north of the 51st parallel from the east side of Lake Winnipeg to the Ontario boundary
- on Matheson Island, when ground travel is not possible by winter road or ferry
Travel must be approved a physician and meet program eligibility. Patients who have coverage from an insurer or funder are not eligible for this medical travel subsidy. Examples include:
- Employers
- Workers' Compensation Board
- Manitoba Public Insurance
- Non-insured people (such as First Nations, Royal Canadian Mounted Police, National Forces)
To process a transport request or for questions about the program, please contact your local office:
Thompson NPTP office
c/o Thompson General Hospital
871 Thompson Drive South
Thompson, Manitoba R8N 0C8
1-800-290-1098
1-204-677-5337
1-204-778-1516
Churchill NPTP office
c/o Churchill Health Centre Division of WRHA
P.O. Box 2500
Churchill, Manitoba R0B 0E0
1-204-675-8361
The Pas NPTP office
c/o The Pas Health Centre
Box 240
The Pas, Manitoba R9A 1K4
1-800-290-1098
1-204-623-9212
Pine Falls NPTP office
c/o Pine Falls Health Complex
Box 2000
Pine Falls, Manitoba R0E 1M0
1-204-367-4441
Flin Flon NPTP office
c/o Flin Flon General Hospital
P.O. Box 340
Flin Flon, Manitoba R8A 1N2
1-800-290-1098
1-204-687-9638
Covered medical devices (ancillary programs)
Ancillary programs:
- Manitoba Breast Prosthesis (MBP) Program
- Seniors Eyeglass Program
- Children's Hearing Aid Program
- Home Hemodialysis Utility Reimbursement Program
- Orthopaedic Shoes Program
- Prosthetic Eye
- Infant Contact Lens Program
- Prosthetic and Orthotic Program
- Telecommunications Program
- Manitoba Adult Insulin Pump Coverage Program
Manitoba Breast Prosthesis (MBP) Program
Who is eligible?
Eligible Women for The Manitoba Breast Prosthesis (MBP) Program:
- Are Manitoba residents;
- Have had a single or bilateral mastectomy; and
- Do not have the costs paid through other provincial or federal programs.
What is covered?
The MBP Program provides financial support to help Eligible Women access a wide selection of breast prostheses and bras post-mastectomy.
Manitoba Health defines the roles, responsibilities and requirements of the MBP Program, and provides funding to CancerCare Manitoba Breast & Gyne Cancer Centre of Hope to administer the program.
What claims can be made?
An Eligible Woman may choose to claim:
- A benefit every two years of:
- Up to $400 per prosthesis to a total of one prosthesis for a single mastectomy; or
- Up to $400 per prosthesis to a total of two prostheses for a bilateral mastectomy; and,
- Fifty dollars ($50) towards the purchase of a bra, OR
- A benefit every four years of:
- Up to $800 per prosthesis to a total of one prosthesis for a single mastectomy; or
- Up to $800 per prosthesis to a total of two prostheses for a bilateral mastectomy; and,
- One hundred dollars ($100) towards the purchase of a bra.
Is there a deductible?
No deductible is required.
For more information about how to participate in The Manitoba Breast Prosthesis Program, please contact:
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Breast & Gyne Cancer Centre of Hope |
Seniors Eyeglass Program
Who is eligible?
Manitoba residents who are 65 years of age and over and do not have the costs paid through other provincial or federal programs are eligible.
What is covered?
The Seniors Eyeglass Program provides financial assistance towards the purchase of eyeglasses for eligible Manitoba residents. Benefits are based on a fixed fee schedule, not on the actual amount paid for dispensing fees, frames and lenses.
Is there a deductible?
There is a $50 deductible on eyeglass reimbursements. If two family members 65 and over require glasses between April 1 and March 31, only one $50 deductible is applied.
How many claims can be made?
One pair of eyeglasses may be claimed every three years – or more often if a medical practitioner or optometrist diagnoses a change in vision.
What items are not covered?
The following items are not covered unless medically required: sunglasses, contact lenses and repairs.
The following are examples of amounts that may be approved according to the fixed fee schedule:
- The allowable amount for dispensing fees varies from $17.50 to $45.00
- The allowable amount for frames is $18.00 for standard frames and $28.00 for medically required frames
- The allowable amount for lenses varies from $6.00 to $43.50 per lens depending on the strength of the lens. If the lenses are bifocal or trifocal, $7.50 to $18.50 may be added per lens.
Examples of reimbursements: Total cost of eyeglasses = $250.00
| Manitoba Health Fixed Amounts | |
|
Dispensing Fees Lenses Bifocal Flat Segment Frame Total Less Deductible Balance |
$35.50 12.00 24.00 18.00 89.50 -50.00 $39.50 |
| 80% of $39.50 = $31.60 (Manitoba Health pays $31.60) | |
How do I submit a claim?
When you pay for your glasses, get a claim form from your supplier and send the completed form to the address below. You can also ask your supplier to submit the claim on your behalf.
For more information, please contact:
|
Manitoba Health Ancillary Programs 300 Carlton Street Winnipeg, Manitoba R3B 3M9 Phone: 204-786-7365 or 204-786-7366 Toll free: 1-800-297-8099 ext 7365 or 7366 FAX: 204-786-6634 TTY/TDD Relay Service: 204-774-8618 outside Winnipeg: 711 or 1-800-855-0511 Email: pharmacare@gov.mb.ca |
Children's Hearing Aid Program
Who is eligible?
Manitoba residents under the age of 18 who require a hearing aid, as prescribed by an otolaryngologist or audiologist, and do not have the costs paid through other provincial or federal programs, are eligible.
What is covered?
Manitoba Health will reimburse:
- 80 per cent of a fixed amount for an analog device, up to a maximum of $500 per ear
- 80 per cent of a fixed amount for a digital or analog programmable device, up to a maximum of $1800
- 80 per cent of a fixed amount for additional services, such as dispensing fees, ear molds, and ear impressions.
How many claims can be made?
One device is allowed per ear every four years, unless there is a medically diagnosed change in the patient’s condition.
Is there a deductible?
There is a $75.00 deductible on all claims.
What is not covered?
- Repairs
- Batteries
- Ear mold Replacements
- Additional ear molds
- Lost hearing aids
How do I submit a claim?
Once they have supplied the hearing device to a Manitoba resident under the age of 18, the audiologist or otolaryngologist will complete and submit a Hearing Aid Claim Form
to Manitoba Health on the individual's behalf.
|
Manitoba Health |
Home Hemodialysis Utility Reimbursement Program
The Home Hemodialysis Utility Reimbursement Program (HHDRP) reimburses patients for the increased costs of utilities related to home hemodialysis treatment. As of May 26, 2019, Manitoba Health is administering the program.
Who is eligible?
The eligibility is determined by the Manitoba Renal Program (MRP). To be eligible for the program, individuals must meet all of the following criteria:
- be a resident of Manitoba
- be found with End-Stage Renal Disease
- be successfully trained for home hemodialysis
- be currently carrying-out home hemodialysis in a dwelling in Manitoba
- pay the dwelling utility bills
- not claim utility costs for tax credit calculations
What is covered?
Reimbursement applies to the cost of utility expenses - electricity and water to operate the dialysis equipment.
Is there a deductible?
No deductible is required.
How do I get reimbursed?
As a patient, you will be asked to provide MRP with a log every time you go to the hospital for your quarterly routine visit. This log gathers:
- number of dialysis treatments per week
- number of hours per treatment
- the flow rate of the dialysis machine
- MRP provides the information about the reimbursement request to Manitoba Health who will send a cheque to your attention.
For further information
For further information about the Home Hemodialysis Utility Reimbursement Program or your claim, please contact:
Manitoba Health |
Orthopaedic Shoes Program
Who is eligible?
Manitoba residents under the age of 18 who require orthopaedic shoes as prescribed by a medical practitioner and do not have the costs paid through other provincial or federal programs are eligible.
What is covered?
Manitoba Health will rebate the following amounts:
- 50 per cent of the cost of stock shoes up to a maximum of $27.80
- 50 per cent of the cost of shoes for children with different sized feet to a maximum of $41.80
- 50 per cent of the cost of custom-made shoes to a maximum of $139.00
An allowance of $5.55 per pair of shoes is also provided for modifications.
How many claims can be made?
Eligible residents may claim two pair of orthopaedic shoes per year plus modifications.
Is there a deductible?
No deductible is required.
How do I submit a claim?
When you purchase your child’s shoes, obtain a claim form from your supplier. Send the completed form and original itemized receipt to the address below.
Manitoba Health |
Prosthetic Eye
Who is eligible?
Manitoba residents who require artificial eyes or cosmetic shells as prescribed by a medical practitioner and do not have the costs paid through other provincial or federal programs are eligible.
What is covered for prosthetic eyes?
Manitoba Health will pay up to a maximum determined amount for artificial eyes or cosmetic shells and related services including building up, refitting, resurfacing and repolishing.
How many claims can be made?
Eligible Manitoba residents may claim one device every two years.
Is there a deductible?
No deductible is required.
How do I submit a claim?
Your prosthetic eye supplier will send the completed forms to Manitoba Health.
Manitoba Health |
Infant Contact Lens Program
What is covered for Infant Contact Lenses?
Contact lenses for congenital disorders in infants are eligible for rebate when prescribed by an ophthalmologist and the costs are not paid through other provincial or federal programs. Manitoba Health will provide one lens per eye, per infant. The maximum allowable reimbursement is $190.00 for a single lens and $380.00 for bilateral lenses.
How do I submit a claim?
When you pay for the lenses, obtain a claim form from the ophthalmologist, optometrist or ophthalmic dispenser. Please send the completed form to the address below:
Manitoba Health |
Prosthetic and Orthotic Program
Who is eligible?
Manitoba residents who require prosthetic or orthotic services, as prescribed by a medical practitioner, and do not have the costs paid through other provincial or federal programs are eligible to receive benefits through the program.
What is covered?
In most cases, Manitoba Health will reimburse the cost of:
- Limb prosthetic devices and services
- Limb and spinal orthotic devices and services
Devices and services provided by a person who is certified as a prosthetist or orthotist by the Canadian Board for Certification of Prosthetists and Orthotists may be eligible.
How many claims can be made?
One device every two years can be claimed unless there has been a medically diagnosed change in prescription or the initial device is damaged beyond repair.
Is there a deductible?
No deductible is required.
How do I submit a claim?
Claim forms can be sent to Manitoba Health by the suppliers of prosthetic and orthotic devices.
Manitoba Health |
Telecommunications Program
Who is eligible?
Manitoba residents who are profoundly deaf or speech impaired as diagnosed by a medical practitioner specializing in otolaryngology or an audiologist and do not have the costs paid through other provincial or federal programs are eligible.
What is covered?
Manitoba Health will provide assistance towards the cost of telecommunications equipment which allows telephone conversations to be conducted by keyboard and display terminal instead of voice. Manitoba Health will pay 80 per cent of the equipment cost to a maximum allowable rebate of $428.00.
How many devices can be claimed?
Manitoba Health will reimburse one telecommunications device every five years.
Is there a deductible?
There is a $75.00 deductible on all claims.
Example of reimbursement:
| Cost of device Less deductible Total |
$509.95 |
80% of $434.95 is $347.96 |
|
How do I submit a claim?
When you pay for your telecommunications device, obtain a claim form from your supplier. Initial claims must be accompanied by a diagnosis from a medical practitioner specializing in otolaryngology or an audiologist. Please send the completed claim form along with receipt of purchase to the address below.
Manitoba Health |
Manitoba Adult Insulin Pump Coverage Program
An insulin pump is a small mechanical device that delivers insulin at a steady rate through a very fine needle inserted under the skin. The Manitoba Adult Insulin Pump Coverage Program (MAIPCP) provides coverage for eligible Manitobans 18 years of age and older with type 1 diabetes who need this device.
Who is eligible?
To be eligible for MAIPCP, individuals must meet all of the following criteria:
- be a Manitoban with an active Manitoba Health Registration number;
- be at least 18 years of age;
- be diagnosed with type 1 diabetes;
- be recommended for insulin pump therapy by an endocrinologist or a physician providing diabetes management care to the individual;
- is currently safely using an insulin pump, or is capable of safely using an insulin pump to assist with managing their blood glucose levels;
- have not received an insulin pump under a Manitoba government funded program within the last 5 years; and
- do not have coverage under a federal program
The MAIPCP came into effect on March 7, 2023. To learn if an insulin pump is right for you, please make an appointment with your endocrinologist or physician to discuss insulin pump therapy.
What is covered?
The MAIPCP will cover the cost of an approved insulin pump ordered from an approved supplier for eligible Manitobans.
A list of approved suppliers, insulin pumps, and supplier contact information is available at: gov.mb.ca/health/mhsip/docs/sdl.pdf.
The MAIPCP will cover one approved insulin pump every 5 years as long as the individual meets the eligibility criteria.
What is not covered?
Insulin pump supplies, such as tubing and reservoirs, are not covered under the MAIPCP.
Insulin pump supplies, along with other consumable diabetes supplies, such as blood glucose test strips and advanced glucose monitors, may be eligible benefits under another federal or provincial program such as, Manitoba's Pharmacare Program. For more information on the Manitoba Pharmacare Program, visit: gov.mb.ca/health/pharmacare/. For more information on coverage of advanced glucose monitors under the Manitoba Pharmacare Program, visit: gov.mb.ca/health/pharmacare/profdocs/faq_agm.pdf.
How can I apply to the program?
Manitoba residents 18 years of age and older with type 1 diabetes can make an appointment with their endocrinologist or physician to discuss insulin pump therapy. Once your endocrinologist or physician confirms insulin pump therapy is right for you, they will submit an application to the MAIPCP on your behalf.
If your application is approved you will receive a letter with instructions on how to order an approved insulin pump, at no cost, directly from the supplier.
Will I have to pay a deductible to get insulin pump coverage?
No, you do not have to pay a deductible to receive an insulin pump.
Can I still receive a pump under the Young Adult Insulin Pump Program (YAIPP)?
No. With the establishment of the broader MAIPCP on March 7, 2023, the YAIPP was dissolved. Coverage of insulin pumps for all eligible Manitobans 18 years of age and older is now provided through the MAIPCP.
How can I get more information?
For more information on whether an insulin pump is recommended for you, contact your endocrinologist or physician.
How do I submit an application?
Endocrinologists or physicians providing diabetes management care to an individual who meets criteria for the MAIPCP will complete and submit a MAIPCP Application Form to Manitoba Health on the individual’s behalf.
For more information on the MAIPCP, contact:
Manitoba Health |
