Paramedical Disciplines
Paramedical disciplines refer to regulated health professionals who provide therapy or rehabilitation services outside of hospital settings. Common examples include physiotherapists, chiropractors, massage therapists, acupuncturists, naturopaths, osteopaths, psychologists, and speech-language pathologists.
How It Works
Paramedical services are healthcare services delivered by trained, licensed professionals who are not physicians or nurses, so they supplement standard medical care without needing a doctor to provide them. Common disciplines include physiotherapy, chiropractic, massage therapy, acupuncture, naturopathy, osteopathy, psychology, podiatry, and speech-language therapy. These services generally are not covered by provincial or territorial healthcare plans, so they are paid instead through workplace benefits or individual healthcare insurance. Paramedical coverage is a subcomponent of the Extended Health Benefit, and it typically accounts for 25 to 30 percent of EHB claims in an average group plan, second only to drugs. Each plan chooses which practitioners are covered, and those practitioners are often required to be licensed, certified, or registered in the province where care is provided. Plans usually reimburse using a coinsurance percentage together with per-visit limits and annual maximums to manage cost and utilization.
Example:
Picture a Canadian worker with a group extended health plan who books regular registered massage therapy and chiropractic visits. Because these paramedical services are not paid by their provincial health plan, the group plan reimburses each visit at its coinsurance percentage, subject to a per-visit cap and an annual maximum. The registered practitioner also has to be licensed in the province where the care is given.
What to Watch For:
Some plans apply a combined annual maximum that is shared collectively across several paramedical disciplines, so once the combined limit is reached, no further claims are reimbursed for any of the included disciplines until the plan renews. Reimbursement is also generally based on reasonable and customary charges, so if a provider charges more than the plan's cap, the member is responsible for the difference. It pays to confirm which disciplines share a limit and how your plan defines its customary rate before booking ongoing care.
