Do Physiotherapy benefits reset in January? For many people, yes. Many workplace extended health plans run on the calendar year, so your Physiotherapy benefits and massage therapy coverage start over on January 1, and unused amounts usually do not carry over. If you have been putting off care for a sore back, neck or shoulder, now is a good time to check your coverage before the new year.
At Excite Physio in downtown Barrie, we get a lot of questions about benefits at this time of year. Here are the ones we hear most.
How do I find out how much Physiotherapy coverage I have left?
The quickest way is your insurer’s app or member website. You can also call the number on the back of your benefits card or ask your HR team. Look for:
- Your annual maximum for Physiotherapy. Some plans list it on its own, and others share one “paramedical” maximum across Physiotherapy, massage therapy, chiropractic and similar services.
- How much is covered per visit, either a percentage (for example 80%) or a dollar limit.
- How much you have already used this year.
- Your plan year dates, so you know exactly when it resets.
Does my plan year actually end on December 31?
Not always. Many plans follow the calendar year, but some run on a different policy year, such as your employer’s fiscal year. Check the dates before you plan around them so you do not rush for nothing, or miss your real deadline.
What can I use my benefits for at Excite Physio?
Depending on your plan, your extended health benefits may cover:
- Physiotherapy, including Pelvic Floor Physiotherapy and Virtual Physiotherapy
- Registered massage therapy
- Counselling and psychotherapy, if your plan includes registered social workers
Every plan is different, so confirm what yours includes before you book.
Do I need a doctor’s note to use my Physiotherapy benefits?
In Ontario you do not need a referral to see a Physiotherapist. Some benefit plans still ask for a doctor’s note before they will reimburse you, and this is more common for massage therapy. If yours does, ask for the note now so it does not hold you up in December.
Can I use my spouse’s benefits too?
Often, yes. If you and your spouse both have extended health coverage, you can usually submit to one plan first and then send the unpaid balance to the other. This is called coordination of benefits. Ask your insurers how they handle it.
What if I have a Health Spending Account?
A Health Spending Account (HSA) works a little differently. Some plans let unused HSA money carry forward for one year, and others do not. Check your plan’s rules so you know whether your balance will still be there in January.
If I need care, should I book before December?
Only book the care you actually need. Your Physiotherapist will recommend a plan based on your assessment, not on how much coverage you have left.
If you already need care, booking earlier gives you more choice of appointment times, since the holidays mean fewer open days in December.
How does billing work at Excite Physio?
We direct bill Sun Life, Green Shield, Blue Cross and many other insurers through TELUS Health eClaims. You can see the full list on our FAQ page. Bring your insurance details to your first visit and we will submit the claim for you. Any amount your plan does not cover is paid at the end of the appointment by cash or credit card, and you get a receipt after every visit.
Excite Physio is at 105 Collier Street in downtown Barrie. If you would like an assessment, call us at 705-279-2759 or book online.
Quick answers (FAQ)
Do unused Physiotherapy benefits carry over to next year?
Usually not. Most extended health plans reset at the start of each plan year, and unused Physiotherapy and massage therapy coverage does not roll over. Some Health Spending Accounts are the exception, so check your plan.
Is massage therapy covered by extended health benefits?
Many workplace plans cover registered massage therapy, often with a yearly maximum. Some plans require a doctor’s note before they will reimburse massage therapy.
Do I need a referral to see a Physiotherapist in Ontario?
No. You can book directly with a Physiotherapist in Ontario. Some insurance plans ask for a doctor’s note for reimbursement, so check with your insurer if you plan to claim.
Does Excite Physio direct bill insurance?
Yes. We direct bill Sun Life, Green Shield, Blue Cross and many other insurers through TELUS Health eClaims. Bring your insurance details to your first visit and we will submit the claim for you.
Written by Christine Pratt, Physiotherapist, Excite Physio.