NIHB compression garments and massage coverage

The Non-Insured Health Benefits program does not cover massage therapy or acupuncture, because they fall outside its six benefit areas. It can cover compression sleeves, gloves and stockings as medical supplies, with prior approval, a prescription from a recognized prescriber, and an enrolled provider who has a certified compression garment fitter. Stockings must be needed for at least six months of daily use at 20 mmHg or more, and short-term use before or after surgery is excluded.

The Non-Insured Health Benefits (NIHB) program gives registered First Nations and recognized Inuit a national set of health benefits. For people with lymphedema or swelling, it splits neatly in two: compression garments can be covered, and hands-on therapy cannot. Knowing where that line falls, and what NIHB expects for garments, saves a lot of back and forth.

What NIHB covers and what it does not

NIHB covers six benefit areas: pharmacy, vision care, dental care, mental health counselling, medical supplies and equipment (MS&E), and medical transportation. Indigenous Services Canada states plainly that health services outside those areas are not covered.

Massage therapy, including manual lymphatic drainage, and acupuncture are not in any of the six, so NIHB does not pay for them. Compression garments, bandages and pumps are medical supplies, so they sit inside MS&E and can be covered when the criteria are met.

Item	NIHB benefit area	Covered
Massage or lymphatic drainage massage	None	No
Acupuncture	None	No
Compression sleeves, gloves and stockings	Medical supplies and equipment	Yes, with prior approval
Compression bandages	Medical supplies and equipment	Yes, with prior approval
Sequential compression pump	Medical supplies and equipment	Yes, with prior approval

Compression garments: the criteria

NIHB’s pressure device list, effective July 29, 2026, sets the rules for compression garments. The main points:

• Compression classes. Sleeves, gloves and stockings are listed in the 20-30 mmHg and 30-40 mmHg classes. Anything over 40 mmHg needs a prescription from a surgeon or specialist.
• Prior approval. Every compression garment needs prior approval before it is supplied.
• Initial prescription. From a physician, physician assistant or nurse practitioner; for stockings, a registered midwife can also write it.
• Renewal prescription. An occupational therapist or physiotherapist can renew.
• Provider. The garment has to come from an NIHB-enrolled provider with a certified compression garment fitter on staff.
• Limits. Four per year for sleeves and gloves, and four per year for stockings. Gloves are for lymphedema only, not arthritis.
• Custom stockings. Measurements must be submitted with the request.

For stockings, NIHB adds that the need must be for at least six months of regular daily use at 20 mmHg or higher.

The exclusions that catch people out

Several common uses of compression are excluded from NIHB stocking coverage, and the first two matter most for people with swelling after surgery or at night:

1. Before or after surgery. Short-term pre and post-surgery use is excluded. A garment for recovery from liposuction, a tummy tuck or another procedure is not an NIHB benefit under these criteria.
2. Night garments. Nighttime use is excluded.
3. Sport socks. Sport compression socks are not covered.
4. Light compression. Stockings under 20 mmHg are not covered.

If you are recovering from surgery, the garment your surgeon prescribes is usually a short-term one; our page on post-surgical compression that feels too tight or too loose can help in the meantime.

Bandages, pumps and how claims are paid

Compression bandages also need prior approval, with a limit of 24 single-use or 6 reusable bandages a year. A sequential compression pump can be purchased once every five years, rented once every three, with a one-month trial rental first; the prior approval request must name the site and cause of the lymphedema.

Express Scripts Canada processes NIHB claims and payments on the program’s behalf. NIHB asks recognized providers to bill the program directly, so clients do not pay up front; Express Scripts Canada also publishes information on client reimbursement for situations where that is not possible. Some requests are reviewed by the NIHB regional office before a decision is made.

Paying for the therapy NIHB does not cover

Because NIHB does not cover lymphatic therapy, people usually look at three other options:

• Alberta Aids to Daily Living (AADL). AADL generally does not cover people who can receive comparable benefits from NIHB, but the Government of Alberta says that if a benefit is not available through NIHB and you are eligible for AADL, you can access AADL benefits. Our page on AADL compression garment coverage explains its rules.
• Workplace or private benefits. If you or a spouse have an employer plan, massage by a Registered Massage Therapist is often a paramedical benefit.
• Public lymphedema services. Ask your physician or nurse practitioner about publicly funded lymphedema services in Alberta that you may be referred to.

Where Renu fits

Renu is a private clinic in West Hillhurst. For an NIHB-funded garment, confirm with Express Scripts Canada or the NIHB regional office which enrolled provider to use before you are fitted. What we can offer is the care around the garment, paid privately or through other benefits.

Meeghan Mackenzie, our founder, is a Certified Lymphedema Therapist and Certified Compression Fitter. A 30-minute compression fitting is $25, and our complete decongestive therapy page explains how lymphedema and lipedema care fits together, including lipedema management sessions of 30 minutes at $105 and 60 minutes at $140. Our page on measuring for compression garments explains what a good measurement looks like, which helps whichever provider you use.

Questions people ask

Does NIHB pay for lymphatic drainage massage?

No. NIHB covers pharmacy, vision care, dental care, mental health counselling, medical supplies and equipment, and medical transportation, and it states that health services outside those areas are not covered. Lymphatic drainage massage and other massage therapy fall outside all six.

Will NIHB pay for my compression garment after liposuction or a tummy tuck?

Not under the pressure device criteria. NIHB lists pre and post-surgery use among the exclusions for compression stockings and requires a need of at least six months of regular daily use. Ask your surgeon's office what garment they recommend and how it is usually paid for.

Can a physiotherapist renew my NIHB compression prescription?

Yes, for sleeves, gloves and stockings in the 20-30 and 30-40 mmHg classes, NIHB lists occupational therapists and physiotherapists as renewal prescribers. The first prescription has to come from a physician, physician assistant or nurse practitioner, or for stockings also a registered midwife.

Does NIHB cover compression gloves for arthritis?

No. NIHB covers compression gloves for lymphedema only, and its list says they do not include arthritis gloves. Gloves count toward the same yearly limit as sleeves.

Sources

1. Indigenous Services Canada: About the Non-Insured Health Benefits program
2. Indigenous Services Canada: Medical supplies and equipment benefits
3. Indigenous Services Canada: NIHB pressure devices benefit list
4. Government of Alberta: AADL eligibility and application for benefits

Page reviewed October 5, 2026. This page is education, not a diagnosis. For your own situation, talk to your doctor, surgeon or care team, or ask us.