Group Health Insurance – Paramedical Practitioners

The second largest cost as a percentage of all Group Health Insurance claims is paramedical practitioners usually accounting from 15% to 25% of claims within a Group Health Insurance plan. Coverage for paramedical practitioners is covered in most health benefit plans, however which practitioners are covered, and at what maximums vary widely from plan to plan. Paramedical practitioners include:

- Physiotherapists

- Registered massage therapists

- Acupuncturists

- Osteopaths

- Chiropractors

- Podiatrists

- Chiropodists

- Naturopaths

- Speech therapists

- Pyschologists

Group insurance benefits contracts of a healthcare plan require the practitioner to be licensed, certified or registered. Coverage is usually provided on two different bases:

- A specified maximum number of visits per year; a maximum amount ($) covered per visit

- A maximum per practitioner per year

- A maximum per year for all practitioners combined

Coverage of treatment provided by some practitioners requires a physician’s referral to be eligible for reimbursement.

Typical reimbursements vary however the general range in most salaried plans is between $300 and $500 per practitioner per covered person annually.It is becoming more common for employers to include both a per practitioner maximum as well as a combined overall maximum to assist in limiting utilization.

Category: Group Benefits