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FAQ's

Frequently Asked Questions

Medical Insurance

What services can I get under my Extended Health Benefit Plan?

Among many other things included into the extended benefit plan Insurance Companies reimburse their clients for paramedical practitioner services (chiropractic, massage therapy, physiotherapy, naturopathy, acupuncture, etc.) within a coverage specified in the insurance policy. You should always call you insurance company to confirm additional details such as max $ per visit, total $ a service per year, coinsurance (%), and if there is any deductible.

How does ICBC/WCB/MSP work?

You might be eligible for ICBC coverage after a motor vehicle accident (MVA). You should contact your ICBC claim adjuster to find out if you qualify as per your ICBC claim. In general ICBC pays $17.35 for a chiropractor visit and $23 for a massage therapy session for a maximum of 12 treatments within the first 8-weeks after a MVA. You can be asked to pay a difference between a health provider private fee schedule and ICBC reimbursement rate. Some practitioners choose not to register with ICBC and they require paying the fee in full. You can file receipts to a claim adjuster after the service has been rendered to get reimbursed. Some practitioners who opted to register with ICBC can invoice ICBC directly. WCB pays for claims to workers who suffer injuries performing work related activities. Again, WCB pays its rate of what a practitioner can charge as per private fee schedule. If you wish a practitioner bill WCB directly you might need to find one who is registered with WCB. Otherwise, you pay for the services and then file a claim. Additional details can be obtained from your WCB claim adjuster.

If you made less than $25,000 income in the previous tax year you are eligible for coverage under the MSP. You are entitled to a combined total of 10 treatments from a Massage Therapist, Physiotherapist, and Chiropractor. As of January 1, 2002, you no longer need a doctor's referral to access your MSP treatments. You could also choose to visit one practitioner for the entire 10 visits. MSP pays $23 a visit and most of the registered health care providers can bill MSP directly.

What is the health care provider's role?

Registered health care providers provide services to the best of their skills and knowledge within a scope of practice as it is specified by their professional associations and colleges. They verify patients' eligibility, when necessary; obtain the authorization to provide the service or benefit. If Medspa bills your EHP directly claims get submitted for payment as appropriate.

How does Extended Benefits Plan work?

Here is an example of how your policy may work. Your policy may read: "We will cover 80% of massage therapy treatments to a maximum of 500".

Treatment cost: TX. $48 EXP will pay: $38.40 Your cost: $9.60

Following this pattern of usage you will have approximately 15 treatments (13tx x $38.40-$499.20) covered by your plan. Your out of pocket costs for these 13 treatments will be $124.80. This is because of the 80% coverage statement in your policy.

The average coverage is around $300-$600 a practitioner per year. To get reimbursed a policy holder should obtain a claim form, complete and mail it out to the service claim Center along with the original receipts enclosed. If you are ensured through your employer group policy you may contact your benefit officer to get a claim form. Also, you can download a claim form from your insurance company web site or even file a claim electronically. You can always call your insurance company customer support to ask them to mail the forms to you.

On a receipt for medical services that you pay for should be stated a service type, date of service, and a registered practitioner name and registration number. You should keep a copy of a receipt that you mail with a claim form.

Do I need a doctor's referral?

In many cases you do not need a doctor's referral to get a reimbursement through your extended benefit plan but you still might need to confirm it to make sure that it goes in accordance with you insurance policy.

What services taken at Medspa Health Centre I can get reimbursed for through my EHP?

Any services offered at Medspa Health Centre that are covered through your Extended Health Paln/ICBC/WCB/MSP can be reimbursed as long as you are entitled as per your insurance policy or eligible based on other insurers criteria.

Book online   or Call Us    (604) 439-1604    to make an appointment.


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