A Complete Guide to Maximizing Your Health Benefits Coverage by Rooted Family Wellness Centre

Extended health insurance plans help provide coverage for hospital and medical expenses not covered by public health plans such as disability and accident costs. These plans also include supplementary health coverage such as prescription medicines, hospital stay, paramedical, vision care, dental care, as well as treatments (like chiropractic, massage) and mental health support. In 2022, over 21 million Canadians had access to supplementary health insurance benefits. (Source). Most Canadians receive these benefits through their employer’s plan while others participate in other forms of a group plan or purchase this type of insurance privately (Source).

While extended health insurance coverage is an invaluable asset that provides coverage for a wide range of services, many people are unaware of the full extent of their benefits and some don’t end up taking full advantage of them even though many people pay out of pocket for some or all of their coverage. Listed below are a few ways on how you can leverage your insurance benefits to embrace holistic wellness through Rooted Family Wellness Centre’s complementary services.

Understanding Your Coverage

Before diving into using your benefits, it's essential to understand your insurance policy thoroughly. Start by reviewing your policy documents or contacting your insurance provider to inquire about coverage details. Policies may vary widely, so be sure to clarify specific terms, limitations, and any pre-authorization requirements. Also be sure to check when the renewal date is. For most, coverage amounts typically resets January 1st while for others it is September 1st (such as teachers).

Check for Supplemental Health Coverage

Read through your insurance plan to see what is covered under supplemental health therapies. Standard plans usually include registered massage therapy, physiotherapy, chiropractic care, naturopathy, mental health and more. New services can be added over time so be sure to check. Some that we know have been added to a few plans recently are: osteopathy, lactation consultants and occupational therapy. Some policies may offer partial or full coverage, while others may require additional riders or special considerations. 

Plan ahead and use your benefits

Once you have a good idea of what is covered and how much, the next step is to plan out when you would like to use them. What we see often is that most people wait until the end of the year to use their benefits only to find that there is no more availability and long waitlists. If you know for example that you have $500 of chiropractic care, start by understanding the fees and what appointment types are available. Then figure out roughly how many visits you can do in a year and then spread those visits out over the months. Work closely with your health team  to develop a treatment plan that aligns with your insurance coverage. If you also have massage therapy coverage, then you can alternate months with chiropractic care to keep your body feeling good. As most places get busy at the end of year, we recommend setting up your fall and end of year appointments in August. 

If you don’t feel like you can use up all of your benefits in one category, we even have classes that can be covered by insurance plans!

Note that some insurance plans may require documentation of medical necessity for certain treatments. If so, consult your primary care physician to discuss your symptoms and obtain a referral or prescription if needed.

Don’t forget your children have benefits too!

Once your children are born, you are able to add them to your health insurance. We have plenty of services for infants and children.

Don't forget that your children are entitled to numerous benefits as well! As soon as your children are born, you can add them to your health insurance plan. We have a wide range of services specifically designed for infants and children. Appointment types that can be claimed under your child’s benefits include: infant feeding support (physiotherapy), lactation consultants, osteopathy (including craniosacral), naturopathy, chiropractic, massage therapy (including our babywearing appointment that can be claimed under registered massage therapy), and acupuncture (tuina massage). 

As your child grows, regular check-ups are essential for maintaining their health, even if they are not currently experiencing any aches, pains or other health issues. These routine visits help ensure that your children are growing and developing properly and can catch any potential health issues early on. By keeping up with these appointments, you're taking a proactive approach to your children's well-being.

Submitting your Claims Promptly

Some wellness clinics have direct billing while others have you pay first and then submit your receipt after. Once you have had your session, promptly submit your claims to ensure timely processing. Keep detailed records of your appointments, including receipts and any documentation required by your insurance provider.

Unlocking the full potential of your insurance benefits involves proactively exploring coverage options and understanding the requirements for alternative therapies like massage, physiotherapy, naturopathy, osteopathy, chiropractic care and more. By navigating the intricacies of your policy and working closely with healthcare professionals, you can optimize your insurance benefits to support you and your family's holistic well-being. Embrace the opportunity to enhance your health and quality of life through the diverse range of services covered by your insurance plan.

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