Sun Life Reasonable and Customary Charges for Paramedical Practitioners

April 10th, 2015

Employer-sponsored Health Care plans generally include coverage for the services of several types of health care practitioners such as chiropractors, massage therapists, and physiotherapists. There’s a range of fees most practitioners in each province typically charge for certain services or procedures. Insurance companies use these “reasonable and customary” fees as the basis for pricing their benefit plans and paying claims.

Most paramedical expenses claimed by plan members fall within the reasonable and customary fee range. If a health care practitioner chooses to charge more, the member is responsible for the extra cost.

The attached chart shows the reasonable and customary charges* for each type of practitioner for each province. Your plan may not cover all the practitioners listed; check your insurance contract if you’re unsure.

Category: Insurance Insights