Chiropractic Coverage and Health Insurance

By Krista DeKuyper | January 9, 2015 | Employee Benefits, Health Insurance, Paramedical Coverage

Chiropractic coverage and health insurance has come a long ways since it first started being practiced over 100 years ago.

For the longest time chiropractic was rejected by the medical community, and chiropractors were held in low regard by medical physicians.

Things certainly have changed for the better though! Nowadays chiropractic is an accepted method of treatment for a wide variety of ailments and conditions.

And there is more good news: chiropractic coverage is available via Canadian health insurance plans!

Note: there are two main types of Canadian health insurance: employee benefits and individual health insurance plans.

Employee Benefits Coverage for Chiropractic

Employee benefits, also referred to as “group insurance”, are offered through an employer. The employer either pays 100% of the premiums, or the premiums are split down the middle between employees and the company (i.e. 50-50).

Unlike personal health insurance plans, group insurance never requires medical underwriting of the insured persons (i.e. no medical exams).

Chiropractic falls under the umbrella of what is called “paramedical” coverage. Paramedical coverage consists of things such as chiropractic, physiotherapy, massage therapy, naturopaths and speech therapy.

The following summarizes employee benefits and coverage for chiropractors:

  • Included as a paramedical coverage
  • Covers “reasonable and customary charges”
  • Limited by annual  plan maximums
  • Sometimes there is a maximum cost per visit (often $20 – $25 per visit)
  • Does not require a referral from a doctor
  • All group plans differ in the amount of coverage they offer, so we do not try to list coverage amounts in this article

Personal Health Insurance Coverage for Chiropractic

Personal health insurance (aka “individual” or “family” health insurance) is NOT provided via an employer. As the name implies, this type of health insurance is purchased on a “per family” basis.

In addition there are 2 types of individual health insurance plans: “guaranteed issue” (no medical) and “medically underwritten” (there are medical questions along with an examination of your medical history). Note that guaranteed issue health plans offer less coverage for the same amount of premium dollar.

The following summarizes these personal health plans and chiropractic coverage:

  • Included as a paramedical coverage
  • Covers “reasonable and customary charges”
  • Usually limited by annual plan maximums (often applied to all paramedical services)
  • There may be a maximum cost per visit
  • There may be a maximum # of annual visits
  • Doesn’t require a referral from a doctor
  • Benefits payable only after yearly maximum allowed under your provincial healthcare plan has been reached (note: as of now there is no general chiropractic coverage offered via ANY  provincial healthcare plan)

(If you are interested in finding out how much these plans cost please use our unique quoting engine for an unlimited number of free quotes).

Specific Health Plans and Chiropractic Coverage

Please refer to the following table for chiropractic coverage from all the personal health plans we offer here at HealthQuotes.ca:

Plan Per Visit Maxmium Max. # of Annual Visits Annual Maximum X-Rays
Flexcare*
(Manulife)
$20 20 No $35 per year
Blue Vision Global
Regular Benefits
(Ontario Blue Cross)
$12 25 No Included in visit maximum
Blue Vision Global
Enhanced Benefits
(Ontario Blue Cross)
$20 25 No Included in visit maximum
PHI
Basic Plan
(Sun Life)
$25 (60% coverage) No $250 per person Included in visit maximum ($25)
PHI
Standard Plan
(Sun Life)
100% coverage No $300 per person 100% (up to annual maximum)
PHI
Enhanced Plan
(Sun Life)
100% coverage No $400 per person 100% (up to annual maximum)
Sonata
Scale 1
(Great West Life)
70% coverage No $300 per person (for all paramedicals) 70% coverage
Sonata
Scale 2
(Great West Life)
80% coverage No $400 per person (for all paramedicals) 80% coverage
Sonata
Scale 3, 4, 5 and 6
(Great West Life)
90% coverage No $500 per person (for all paramedicals) 90% coverage
FollowMe**
Basic Plan
(Manulife)
$15 20 $600 per person (for all paramedicals) $35 per year
FollowMe**
All Other Plans
(Manulife)
100% coverage No $600 per person (for all paramedicals) $35 per year
Blue Vision Express**
(Ontario Blue Cross)
$12 25 No $25 per year

* DentalPlus and ComboPlus Starter plans are guaranteed issue. All other plans are underwritten.
** Guaranteed issue health insurance plan (no medical questions)

Conclusion

We hope you found this blog article about chiropractic coverage via Canadian health insurance helpful.
Feel free to contact us, we always welcome your feedback!