Using extended health benefits for massage therapy
Many employer and private health plans include some level of massage therapy coverage, but benefit contracts are not standardized. Reimbursement can depend on the individual plan, the practitioner’s eligibility, annual or combined maximums, deductibles, co-insurance, insurer-set eligible-charge limits and claim documentation.
What to check before booking
- Whether massage therapy is included in your current plan.
- Whether the individual practitioner must be licensed in British Columbia.
- Your remaining annual or combined paramedical maximum.
- Any deductible, reimbursement percentage or per-visit limit.
- Whether your plan requires a referral or prescription for reimbursement.
- Whether the clinic can direct bill your specific insurer.
Direct billing is not a guarantee of coverage
A clinic may be able to submit a claim electronically, but the insurer still applies the terms of the member’s plan. Patients remain responsible for confirming their own coverage and for any amount the plan does not reimburse.
Two benefit plans
When a person is covered by more than one group health plan, coordination-of-benefits rules determine the order in which plans consider a claim. Combined reimbursement cannot exceed the eligible expense. Confirm the applicable sequence with the insurers or plan administrators.