On December 1, 2004, the Ontario Government made a significant announcement, terminating their 30-year practice of partially funding chiropractic patient care. Consequently, a portion of the cost—$11.75 for the initial visit and $9.65 for subsequent visits, capped at $150 annually—will now be the responsibility of patients.
Chiropractic, much like other health services not covered by OHIP (e.g., dentistry, psychology), remains an essential aspect of the healthcare system and your healthcare team. At our office, you will continue to receive top-tier care and attention.
Many health insurance plans encompass chiropractic coverage. We recommend reviewing your plan or engaging with the plan administrator to determine how your treatment can be financially supported. We are here to assist you in completing any necessary forms.
What does the discontinuation of OHIP funding mean for my Private or Extended Health Care (EHC) plan coverage?
As of December 1, 2004, the Ontario government has shifted the entire cost of chiropractic care to patients and EHC plans. Previously, the provincial government contributed $9.65 per visit for approximately 15 visits.
Budgetary 'public health spending' reductions by the Ontario government have also impacted physiotherapy services provided by registered physiotherapists in Ontario.
Whether your EHC plan will cover this cost transfer is contingent on the plan sponsor, typically your employer. If your plan previously had no coverage until your OHIP coverage was exhausted, you may now be able to access your chiropractic coverage immediately (i.e., no out-of-pocket costs up to your plan's maximum). Some plan sponsors (employers) may have introduced a deductible.
We recommend consulting with your employer (e.g., Human Resources Department) or union to ascertain if your EHC plan will absorb the transferred costs from the public system and to understand your coverage precisely after December 1, 2004.
Pose the following questions...
- Does the plan provide for coverage for chiropractic services? This is often included under paramedical services.
- How much of my chiropractor's fee will be paid by the EHC plan? Coverage may be: an amount per visit (i.e. $50. per visit), or a percentage of your chiropractor's fee (i.e. 80% of the total fee), or your plan may provide for a deductible, either a portion of the individual fee (i.e. $10. per visit) or a set amount per year before coverage begins.
- Is there an annual limit on my chiropractic coverage? Many plans will limit the total spending on chiropractic care (i.e. a maximum expenditure per year). Let your employer and/or union know that chiropractic coverage is important to you. Also tell them the level of coverage for chiropractic services you wish to be included in your EHC plan.
- What is the role of my chiropractor in dealing with my EHC plan? Dr. Pisarek is there to provide important health care services to you. This is his most important role. He will also help you to understand the fees associated with chiropractic care and will provide you with the information necessary to allow you to submit your chiropractic expenses to your EHC plan. He may also help you fill out your insurance form.
You can also contact the Ontario Chiropractic Association directly at: 20 Victoria St., Suite 200, Toronto ON M5C 2N8, Tel: 416-860-0070, or toll-free at 1-877-327-2273, Fax: 416-860-0857. Email: [email protected]; Website: www.chiropractic.on.ca
For further information contact Advanced Healthcare at (416) 633-3000
to speak to Dr. Pisarek, or send him an email: [email protected].