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Legitimate massage/RMT question - Covered by employment benefits/insurance?

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Guest *rb*n C*wb*y

Quite off-topic considering there will be no happy ending, but I'm intrigued by therapeutic massages. I'm under some stress lately and I can feel my body being more tense than usual.

 

I've heard that massages from legitimate places are covered under employment benefits/insurance. How exactly does this work? I am with the PSHCP (Public Service Health Care Plan) with Sun Life Financial. I go to my hypothetical massage appointment, then what? I magically get reimbursed for the whole amount?

 

Pretend I'm 5 years old and don't understand how anything works, so a clear and simple explanation of the process would be greatly appreciated.

 

Also, how much can I expect to pay per unit time? I don't suppose we're violating certain rules about not discussing pricing if it's therapeutic massage, correct? ;)

 

Thanks in advance! :)

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Guest N***he**Ont**y

In cases of engaging the services of a RMT you ask for a receipt after paying the RMT in cash debit etc and then submit to your insurance carrier. You are billed by the length of time such a a 30 minute, 60 minutes or 120 minutes depending on what your request is.

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When you claim massage therapy you basically have to follow the instructions as per you insurance company require. Most likely there is a form to fill out., also there is most likely a limit on the ammout you can claim for the massage, you filled out the form submit your official receipt. , in which information about the RMT or the massage therapist professional has to put all her information., such as business address, Name, licence number, etc... Then most likely depending you will get a cheque in the mail once they verify the claim.. or some companies also use direct deposit.

 

ps: I would not take a chance of mixing pleasure with real therapy massage.. it is illegal.. it is fraud... From your part and from the lady if she offers you... she is also putting at risk her professional credentials.

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Speaking as an RMT, here is what you need to know.

 

You call up the clinic/RMT and book the appointment, they will then tell you if you are paying by timeframe or treatment. If you pay for timeframe it is from when you walk into the clinic room to when you walk out of the clinic room (most therapists will give you an extra 5-10 minutes). If it is treatment time you are paying for then you will have your problem area assessed and treated, if that take 15 minutes or 60 minutes the rate will remain the same.

 

Most common practice is timeframe because it makes scheduling easier for the client and therapist.

 

Now, Sunlife is a b**** to direct bill to. Trust me, I know I have tried. If the clinic says they will direct bill lucky you, however if you were coming to see me you would be getting a receipt. The receipt has all the information you need to put on the form that is available online to submit your claim.

 

This means you pay for the service, lets say $60 for 1 hour. you then take you receipt and fill out the form and submit your claim. If your claim is approved Sunlife will direct deposit the % you are entitled to into your account. Generally the % covered is 80% of the bill. So you will have paid $12 for your massage, lucky you.

 

Also be aware that GST is required, so it may cost you an additional 5%.

 

Also as a RMT I encourage you to tip, it is greatly appreciated and it surprisingly doesn't happen that often.

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I am with the PSHCP (Public Service Health Care Plan) with Sun Life Financial. I go to my hypothetical massage appointment, then what? I magically get reimbursed for the whole amount?

 

For the PSHCP you will need to get a referral (aka prescription) from a doctor in order to claim. Once you have had your appointment and paid you will take the receipt the RMT gave you, the referral and your completed sunlife claim form and mail it in to sunlife.

 

You will eventually receive .80% of the appointment back, based on the rates in their schedule, which do not often match what is charged in the real world. i.e. RMT charges $75 and hour. Sun life thinks they should be charging $60. Sunlife will pay you 80% of $60. This is more common on the dental side of things. There is a yearly maximum claim amount' that they will re-imburse the percentage of (i.e. if the claim amount limit is $500, the most you will get back is $400). Also, there is a yearly deductible that is subtracted from your early claims until it is paid off.

 

If you can get the doctors note it is well worth taking advantage of. Lots of people in the office do.

Edited by OSaab
typo

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If you are under the PSHCP then first you need to go to a doctor. They will prescribe any kind of therapy you need, and then depending on where you go to get the treatment, you may need to submit bills. Some RMT`s are affiliated with medical clinics and they can submit the bills like when you go to the dentist. But you will have to pay on the day you get treatment and then get reimbursed.

 

The key thing, you need a Doctor to recommend. Otherwise, not eligible.

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Also, for the PSHCP, if services are rendered in Ontario it has to be an RMT, if services are in Quebec, it can be an Orthotherapist <sp? >. You can get all of the info you need either by calling Sun Life, or going to the website.

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Guest *rb*n C*wb*y

A gracious thanks to everybody who shared information with me. This has been very enlightening. I now have what I need to investigate the matter further. Many thanks! :)

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I've done it multiple times and it's very easy

 

- ask if they are certified

- get a receipt in my case they were all signed by the licensed massager

- get a note from a doctor than in fact massage would be benifical for your condition

- submit the receipt and doctor note to your insurance provider

- the doctor note is typically good for 1 year

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