Using your Métis Health Benefits

Once you are approved for Métis Health Benefits, you can use your coverage to help pay for drug, dental, vision, and medical supply costs. This page explains how to use your benefits at pharmacies and other providers, what to do if you must submit your own claim, and the rules that apply while you are covered. 

Many pharmacies, dental clinics, optical providers, and medical supply vendors can bill the program administrator directly. When direct billing is available, you will not need to pay the full cost upfront.

If a provider cannot bill directly, you may need to pay first and submit a claim for reimbursement.

If you pay for an eligible service or item yourself:

• Keep all receipts and supporting documents.
• Submit your claim for reimbursement following program rules.
• Claims must be submitted within the required timeframe.
• You must use any employer or private insurance coverage before submitting a claim to Métis Health Benefits.

If a biosimilar version of your medication exists, you must use it.

Original brand-name versions are only covered by exception.

Extended Health Benefits are the payor of last resort. If you have employer or private insurance, you must use that plan first before EHB can help with any remaining eligible costs.

For dependent children, both parents or guardians must provide information about other coverage.

Your Métis Health Benefits may help with:

• Prescription drugs that meet program rules
• Dental services and products
• Vision care such as eye exams, eyeglasses, and lenses
• Medical supplies and equipment prescribed by a health care provider
• Medical travel required to access eligible benefits