In-country Coverage and Claims

Inside New Brunswick

New Brunswick Medicare pays for the following insured practitioner services:

• most medically required services provided by a physician in either a physician’s office or in an approved hospital; and
• certain specified surgical dental procedures provided by a dentist when the service is medically required and rendered in an approved hospital. (Please note that extractions and dental work are not insured services even when performed in a hospital. However, anesthesia for dental procedures may be covered in specific circumstances.)

Medical practitioners in New Brunswick may choose either to bill New Brunswick Medicare or to bill you directly for an insured service. Those who choose to bill you in excess of Medicare rates must advise you before providing the service, and you must sign a waiver form agreeing that New Brunswick Medicare will not reimburse you any amount.

New Brunswick hospitals do not bill New Brunswick residents for insured hospital services. These services must be provided in an approved hospital facility and are paid for by the Government of New Brunswick.

A New Brunswick Medicare card allows you to access the following insured hospital services:

• standard hospital accommodation and meals;
• necessary nursing service;
• drugs administered while in the hospital;
• operating room, delivery room and anesthetic facilities;
• laboratory, X-ray, and other diagnostic services as deemed necessary;
• therapies such as physiotherapy, occupational therapy, speech therapy and audiology;
• radiotherapy; and
• routine surgical supplies.

The following products and services are not insured by either New Brunswick Medicare or by the province’s hospital services:

• abortion (unless the abortion is performed by a specialist in the field of obstetrics and gynecology in an approved hospital facility and two physicians certify in writing that the abortion is medically required);
• acupuncture;
• advice or prescription renewal by telephone;
• ambulance services, as well as transportation costs to and from your place of residence to obtain medical or hospital services;
• anesthesia for dental work (except for specific circumstances);
• artificial insemination;
• blood taken in a doctor’s office;
• breast enlargement for cosmetic purposes;
• circumcision of newborns;
• complete medical examinations for the purpose of an annual check-up;
• dental services provided by a physician;
• dentures;
• drugs and medicines;
• elective plastic surgery or other services for cosmetic purposes;
• examinations, immunizations, diagnostic or other services at the request of any third party for the purposes of employment, travel, emigration or insurance;
• eye-glasses, frames or contact lenses, as well as refractions for prescription eye-glasses;
• gastric stapling or gastric bypass (stomach stapling);
• hospital visits solely for the administration of drugs, vaccines, serums or biological products;
• hypnosis;
• immunizations which are available through Public Health clinics, unless medical reasons require that they be given by a physician;
• medical materials;
• medications for the patient to take home from the hospital;
• otoplasty (correction of prominent ears) for those over 18 years of age;
• prosthetic devices or appliances, artificial limbs and such returnable items as walkers, special crutches and braces;
• removal of minor skin lesions such as warts – except when cancer is suspected;
• reversal of tubal ligation and vasectomy;
• services covered by the Workplace Health, Safety and Compensation Commission of New Brunswick, the Department of Veterans Affairs or under other legislation;
• services generally accepted within New Brunswick as experimental or that are provided as applied research;
• services provided by: chiropractors,chiropodists, dentists (except as stated previously), massotherapists, naturopaths,opticians, optometrists, orthodontists, osteopaths, pharmacists, physiotherapists, podiatrists, psychologists or private duty nurses;
• subsequent injections for impotence following initial injection;
• surgical supplies; and
• the difference in rate between standard hospital accommodations and a semi-private or private room.

The information provided here is not intended to cover all instances. If you are unsure whether the service you will receive is an insured one, please discuss the issue with your physician. Should you receive a bill for hospital or physician services, please communicate with either the service provider or the institution.