Manitoba provincial health plan fact sheet

Your Manitoba Health Services Plan provides:

Prescription drugs

  • 100% coverage for eligible drug expenses listed on the Manitoba drug formulary after a deductible has been satisfied
  • Deductible rates are based on your adjusted total family income and can be obtained from the Pharmacare websiteOpens a new website in a new window
  • Effective June 15, 2017, Manitoba Pharmacare & Employment and Income Assistance limits annual quantity for blood glucose test strips based on the diabetes treatment the patient is receiving:
Treatment category Annual quantity limit
Managing diabetes with insulin 3,650
Managing diabetes with anti-diabetes medications with a high risk of causing hypoglycemia 400
Managing diabetes with anti-diabetes medications with a low risk of causing hypoglycemia 200
Managing diabetes through diet/lifestyle 200
 
  • Effective Aug.18, 2017, Manitoba introduced a dispensing fee cap. Pharmacies will be able to charge provincial drug programs up to$30 per prescription, regardless of the base cost of a drug or how a drug is packaged (such as in a pill bottle or blister pack).
  • Pharmacies will be able to charge Pharmacare up to $30 for compounding services in a pharmacy (when medicinal ingredients are mixed and prepared to meet an individual patient's clinical needs).

Ambulance

  • No coverage for ground ambulance services with the exception of medically necessary hospital-to-hospital transfers for those that meet the criteria
  • Coverage for air ambulance transfers may be available for those that meet the criteria

Dental benefits

  • No coverage for routine or major services (i.e. cleanings, fillings, extractions, endodontics, periodontics, crowns, bridges, dentures, etc.)
  • No coverage for treatment of accidental injury to teeth
  • Coverage for services provided by a dental surgeon, for specific procedures performed in a hospital

Vision care

  • No coverage for eye exams, glasses or contact lenses (limited coverage for seniors)
  • Coverage for one complete routine eye exam every 24 months for residents age 18 and under or age 65 or older
  • Coverage for residents 65 years of age and over for 80 per cent of a fixed amount for eyeglasses once every three years.  A $50 family deductible on eyeglass reimbursements applies.
  • Coverage for exams for all ages if deemed medically necessary by your physician or optometrist

Hospital

  • Coverage for standard ward rooms only, normal in-patient services and certain hospital out-patient services

Paramedicals

  • No coverage for psychologist, massage therapy, naturopath, osteopath, acupuncture or podiatry services
  • Coverage for chiropractic manipulations and adjustments of $12.10 per visit ($13.30 north of the 53rd parallel), to a maximum of 12 visits. No coverage for X-rays. 
  • Coverage for physiotherapy, speech therapy or dietetic counseling when performed in a hospital

Hearing aids

  • Coverage for children ages 18 and under, every 4 years, after a $75 deductible has been met:
    • 80% of a fixed amount for an analog device, up to a maximum of $500 per ear 
    • 80% of a fixed amount for a digital or analog programmable device, up to a maximum of $1800 
    • 80% of a fixed amount for additional services, such as dispensing fees, ear molds, and ear impressions 

Nursing benefits and home care

  • Coverage for basic nursing care in a personal care home for those that meet the criteria 

Medical supplies

  • 100% coverage for the cost of the following when provided by a certified individual 
  • Limb prosthetic devices and services
  • Spinal orthotic devices and services

Accidental death and dismemberment

  • No coverage.

Out of country

  • Coverage for emergencies only. Emergency services are reimbursed at a rate equal to what a Manitoba doctor would receive for a similar service.
  • Coverage for emergency hospital care is paid on an average daily rate established by Manitoba Health.

These highlights from the Manitoba Health Services Plan are for general reference only and are subject to change, corrections and updates. Other government programs may also be available. For more information on the latest coverage details, contact:

Insured Benefits Branch, Manitoba Health
300 Carlton Street
Winnipeg, MB R3B 3M9

In Winnipeg, call 204-786-7101
Winnipeg Deaf Access Line TTY/TDD: 204-786-7132
Outside of Winnipeg, call toll-free 800-392-1207

Outside of Winnipeg deaf access phone: The Manitoba Relay Service at 711 or 1-800-432-4444 to reach the above number.

ManitobaOpens a new website in a new window

 

Updated: August 2019