Many workplace benefit plans in Ontario run on the calendar year. Whatever you don't use for physiotherapy, massage therapy or chiropractic by December 31 is gone, and the new year starts from zero. Here's how to check where you stand.
Step 1: Find your plan details
Log in to your insurer's app or member site. You need three things: the name of your insurer, your plan or group number, and your member ID. These are also on your benefits card.
Step 2: Look for "paramedical" coverage
Physio, massage and chiro usually sit under a heading like paramedical, health practitioners or extended health. For each service, note:
- The yearly maximum (for example, $500 a year for massage therapy)
- The amount you've already used
- The percentage covered (often 80% or 100%)
- Any per-visit limit, such as $60 per visit
- Whether a doctor's referral is required
Step 3: Plan your visits
Divide what's left by your per-visit cost. If you have $300 left for massage and a visit costs $120 with 80% coverage, that's about three visits before the year ends. Book them now; December evenings fill up fast.
Step 4: Check spouse coverage
If your partner has a plan too, you may be able to claim the part your plan doesn't cover under theirs. That's called coordination of benefits, and it can bring your out-of-pocket cost close to zero.
Short on time? Book a free 10-minute Benefits Check at Alleve Wellness Clinic on Weston Rd in Vaughan. Bring your benefits card or app and we'll go through it with you, then plan visits that use what's left.
Every plan is different. Your insurer has the final word on what's covered.