How to Use Your Health Benefits Before the End of the Year
If your extended health plan runs on the calendar year, any chiropractic or massage coverage you don't use by December 31 is gone. Most of the plans I see at our Kanata clinic cover about $500 a year for chiropractic and another $500 for massage, so that's up to $1,000 of care you won't get back. November is a good month to use your health benefits before the end of the year, while there's still time for a few visits before the holidays fill your calendar.
How do chiropractic and massage benefits work?
Most plans give you a yearly dollar amount for each service. The most common one I see is $500 for chiropractic and $500 for massage, though it varies by employer. Your plan then pays a percentage of each visit, usually 80, 90 or 100 percent, until you reach that maximum. At 80 percent, you cover 20 percent of each visit yourself. At 100 percent, you pay nothing until the yearly amount runs out.
A few details catch people off guard. Some plans give each service its own maximum. Others pool chiropractic, massage and physiotherapy into one shared amount, so a few massages can eat into your chiro coverage. Some plans also cap what they'll pay per visit. Most don't need a doctor's referral for chiropractic, but some do require one for massage.
Check your renewal date too. Many plans reset on January 1, and some follow the employer's plan year instead.
How to check what you have left
Log in to your insurer's app or website and find your remaining balance for chiropractic and massage.
Note your coverage percentage and any per-visit limit.
Find your plan's renewal date.
If massage needs a referral, book that doctor's appointment now. Getting in can take a few weeks.
Why November is a good time to use your health benefits
If something has been nagging you, this is the time to get a few sessions in close together without blowing your budget. Visits a few days apart let us build on each one and work through tension and mobility problems. You also leave with a plan you can keep doing on your own in January, and it won't cost much out of pocket.
That might be a shoulder that's been sore since slo-pitch season, a low back that tightens up after heavy deadlifts, or a neck that hasn't felt right since you went back to the office three days a week.
Performance goals count too. If you want to squat deeper, train for a spring half marathon or get through hockey season without your hip acting up, a few visits now can sort out what's holding you back and get you on a program.
If nothing hurts, a quick check-in is still worth it. We'll look at how you move, point out anything worth keeping an eye on and update your home exercises. We won't push you into care you don't need. Your coverage expires at the end of the year either way, so it's a good time to get things looked at.
What a year-end visit looks like at Highlands
Your first visit starts with an assessment. We talk through what's going on, test how you move and figure out what's driving the problem. Then we treat it. Chiropractic adjustments and soft tissue work help stiff joints move better, and acupuncture or dry needling can help settle down an irritated area. Before you leave, you'll have a short list of exercises to do at home so progress keeps going between visits and after your coverage resets.
How many visits you need depends on what we find. A nagging problem usually takes a few visits over a few weeks. A check-in might be one.
Some of my patients like to book a massage and a chiropractic visit on the same day. The massage gets the muscles loosened up and moving, and the chiropractic care helps the joints move better. If your plan has separate maximums for chiro and massage, it's also the simplest way to use both before they reset.
Does Highlands direct bill insurance?
We direct bill RCMP and Veterans Affairs Canada plans through Blue Cross for chiropractic care. For other plans, ask when you book and we'll explain how billing works with your insurer.
When you shouldn't wait for a benefits deadline
If you have pain with numbness, tingling or weakness in an arm or leg that's getting worse, book with us or your family doctor this week. Loss of bladder or bowel control, or numbness in the groin or inner thighs, needs emergency care right away.
Frequently Asked Questions
Do unused health benefits roll over to next year?
On most plans, unused chiropractic and massage maximums disappear when the benefit year resets. Health spending accounts follow different rules, and some let unused credits carry forward one year. Check with your plan administrator.
Do I need a doctor's referral for chiropractic or massage in Ontario?
Most extended health plans don't need a referral for chiropractic care. Some plans do need one for massage therapy before they'll pay a claim. Your benefits booklet or your insurer's app will tell you.
Is chiropractic covered by OHIP?
No. OHIP stopped covering chiropractic care in 2004, so coverage comes through extended health plans or programs like Veterans Affairs Canada and the RCMP.
Is it worth booking if nothing hurts?
It can be. A check-in lets us look at how you're moving, catch small problems early and update your home program. We'll tell you if you don't need more visits.
If you have chiropractic or massage coverage left this year, book an assessment with Dr. Josh Kiely or Dr. Stephanie Bonneau, or a massage with Adam Bourne or Alexandra Desilets, at our Kanata clinic on March Road.
