# Thursday, 31 May 2018
                 
Massage Therapy Coverage
Massage therapy is a very popular health insurance benefit that is used regularly by many people.

Not surprising, considering how a massage feels great and is very relaxing!

But is massage therapy really a valid health insurance benefit? And how much coverage for registered massage therapists is actually provided by a typical health insurance plan?

Read on and we will explore these questions together.

What is Massage Therapy?

Massage therapy is simply the act of massaging with the purpose of facilitating wellness and healing in a patient.

When we refer to massage therapy in the context of insurance coverage we are always talking about massage performed by a registered massage therapist (i.e. a person who has studied and received accreditation for therapeutic massage).

Massage therapy is classified as a paramedical coverage, which also includes benefits for treatment by chiropractors, psychologists and physiotherapists (to name just a few).

Medical Benefits of Massage Therapy

Massage therapy feels great and also has the following health benefits:
  • It has been found to be an effective treatment for back pain (especially for the lower back).1
  • It improves circulation of the massaged area as well as overall circulation in the body.
  • Massage therapy can be used to treat and prevent tension headaches.
  • It can be used to boost the immune system by increasing the white blood cell count in patients.2
  • It can help improve sleeping habits, especially patients who are undergoing chemotherapy or radiation treatment for cancer.
  • Massage therapy can improve joint mobility.
  • It can also reduce tension in the body, which has many negative health effects.
Massage therapy is widely used to treat both chronic ands acute medical conditions that can result from either an injury or illness.

Provincial Healthcare Coverage for Massage Therapy

Provincial healthcare plans such as OHIP, AHCIP and MSI form the basis of the universal Canadian healthcare system (for more information see How Does Canadian Healthcare Work?).

These publicly funded healthcare plans provide coverage for medically necessary services only, however. As a result, most registered massage therapy is not covered by public healthcare.

The exception to this may be massage therapy that is received in a hospital and is deemed necessary to the recovery of a patient.

Employee Benefits Coverage for Massage Therapy

There are two main types of private health insurance in Canada: employee benefits and individual health insurance plans.

Employee benefits are also called "group insurance", and coverage is obtained through your employer. If you lose your job then you also lose your benefits coverage.

Massage therapy is just one of the coverages that come under what is called "paramedical" benefits. As mentioned previously, paramedical coverage consists of things such as chiropractic, physiotherapy, massage therapy, naturopaths and speech therapy.

The following summarizes employee benefits coverage for massage therapists:
  • Included as a paramedical coverage.
  • There is usually no “per visit” maximum (unlike a personal health insurance plan).
  • Coverage is limited by annual plan maximums that are applied to each type of paramedical coverage (e.g. one maximum per coverage type).
  • Most group plans require a referral from a doctor.
  • Annual coverage maximums range anywhere from $350 to $750 per year.
  • Generally speaking, employee benefit maximums are higher than maximums with individual health plans.

Individual Health Insurance Coverage for Massage Therapy

Individual health insurance is also called "family health insurance" or "personal health insurance". It is not obtained via an employer, rather, it is purchased on an individual basis.

Coverage remains in force for as long as the premiums are paid.

Similar to group insurance, individual health plans also categorize massage therapy as a paramedical coverage.

Unlike group insurance, individual plans usually have "per visit" maximums and some plans also have a maximum number of visits per year.

Per-visit maximums are usually around $20 per visit.

The following summarizes massage therapy coverage via personal health insurance plans:
  • Included as one of the paramedical coverages.
  • Coverage is limited by annual plan maximums (often applied to all paramedical services lumped together).
  • There is usually a maximum cost per visit.
  • There may be a maximum number of visits annually.
  • Most personal health plans require a doctor’s referral for massage therapy. The exception to this is Manulife’s Flexcare and FollowMe plans, which do not require a referral when you enter your 3rd year of coverage.
The following table outlines the amount of massage therapy coverage that is available via the personal health and dental plans that we offer here at HealthQuotes.ca:
Plan Per Visit Maxmium Max. # of Annual Visits Annual Maximum
Flexcare
(Manulife)
$25 20 No
Blue Vision Global
Regular Benefits
(Ontario Blue Cross)
$20 20 No
Blue Vision Global
Enhanced Benefits
(Ontario Blue Cross)
$25 20 No
PHI
Basic Plan
(Sun Life)
60%, up to $25 No $250 per person
PHI
Standard Plan
(Sun Life)
100% coverage No $300 per person
PHI
Enhanced Plan
(Sun Life)
100% coverage No $400 per person
Sonata
Core Plan
(Great West Life)
$30 No $300 per person
Sonata
Elite Plan
(Great West Life)
$40 No $400 per person
FollowMe*
Basic Plan
(Manulife)
$15 20 No
FollowMe*
All Other Plans
(Manulife)
100% coverage No $650 per person (all paramedicals combined)
Blue Vision Express*
(Ontario Blue Cross)
$15 20 No

Massage Therapy Usage and Claims Abuse

Massage therapy is very popular insurance benefit. According to The Sanofi Canada Healthcare Survey in 2016, almost half of the plan members included in the survey had submitted at least one claim for massage therapy during that benefit year.

While there are some cases where massage therapy is medically required for a person’s recovery from an illness or injury, there is no doubt that many claims are by people who just enjoy getting a massage and having it paid for via their group insurance plan.

But is this really claims abuse? It depends on who you talk to. On the one hand, massage has numerous health benefits, and having healthier and happier employees should be worth something to the company who is footing most (or all) of the bill.

On the other hand, most employee benefits plans take into account the claims amount when it comes to renewal time. The greater the claims amount is, the more the premiums will increase. The end result is that massage therapy claims for non-existent injuries or illness will increase the premiums to be paid.

Maybe we should let the folks who are paying the bill decide if they want to pay for all massage therapy, whether or not it is “medically necessary”? Food for thought!

Conclusion

We sincerely hope you found this article about massage therapy coverage via health insurance plans useful.

You are welcome to leave a comment below or contact us if you have any questions. It is our mission as experienced, licensed Canadian insurance brokers to help you get the coverage that best suits your particular situation!

* These plans are guaranteed issue (no medical questions).


Sources

1 A Comparison of Massage Therapy and Usual Medical Care for Chronic Low Back Pain
2 Massages Boost the Immune System
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