OHIP Delisting Update - What Happened?

The Government of Ontario delisted chiropractic co-payments on December 1st, 2004.  Over 600,000 signatures and individual letters were sent to government by Ontarians calling for the reversal of this decision.

Some Physiotherapy and Optometry services were also de-listed in Ontario.

Thank you to all of our patients who signed our petition and voiced their concerns to the government.

Your Questions:

Now that OHIP has been delisted, how does it affect me?

If you have extended benefits for chiropractic, you will likely benefit from OHIP being delisted.  Your extended health benefits plan will likely pay for a portion or all of your chiropractic care up to your plans yearly limit. This potentially reduces the out-of-pocket fees that you formally encountered when OHIP co-payments were in place.   If you don’t have benefits, the cost of chiropractic care has only risen slightly and it is still one of the most cost-effective and effective treatments available .

I don’t have benefits.  How much have the fees increased?

OHIP previously reduced your fees by about $10 per treatment.  Depending whether you are a child, student, senior, or adult, costs have risen from $5-$10 with respect to our previous fees.

Some Good News.

Our office has introduced a new Students and Seniors Fee. In addition, we now offer grouped treatment packages ("Block Fee Packages") that further reduce treatment costs (e.g. cheaper by buying in bulk).  The treatment packages have been well received.  They offer cost savings and convenience to our patients.

 

Chiropractic remains an affordable and effective treatment solution for your health care needs.  We are pleased to serve on your health care team.   

 Click HERE to view our New Fee Schedule

For more information about the delisting, please read below.

--- Effective December 1, 2004 ---

The Government of Ontario has announced that, on December 1, 2004, after 30 years of assisting chiropractic

patients by providing partial funding, it is withdrawing that assistance. This shifts part of the cost, $11.75 per initial

visit and $9.65 per subsequent visit (to a maximum of $150 per year), from OHIP to patients.

 

Like several other health services that are not OHIP funded (i.e. dentistry, psychology) chiropractic remains an

important part of the health care system and your health care team. You will continue to receive the highest quality

care and attention we can provide. 

 

Many health insurance plans cover chiropractic. Check your plan or speak to the plan administer to determine how your treatment may be paid for.

What does the elimination of OHIP funding mean for my Extended Health Care (EHC) plan coverage?

As of December 1, the Ontario government has transferred (downloaded) the entire cost of chiropractic care to patients and EHC plans. Previously, the provincial government provided $9.65 per visit for approximately 15 visits.

 

Whether your EHC plan will absorb this transfer of costs will be determined by the sponsor of your plan .  Generally, this is your employer.  If your plan previously provided 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 plans maximum.)  Some plan sponsors (employers) may have added a deductible.

 

You should check with your employer (i.e. Human Resources Department) or union to determine whether your EHC plan will absorb the transfer of costs from the public system and determined exactly what your coverage is after December 1, 2004.

 

Ask the following:

? 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. $30 per visit), or

- a percentage of your chiropractor's fee (i.e. 80% of the fee), or

- your plan may provide for a deductible, either a portion of the individual fee (i.e. $10/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?

Your chiropractor is there to provide important health care services to you. This is his/her 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.

 

If you have additional questions, be sure to ask your Dr. Nyman.

 

Ontario Chiropractic Association 5160 Explorer Drive, Unit 30, Mississauga ON L4W 4T7

905 629-8211 877 327-2273 fax 905 629-8214 e-mail oca@chiropractic.on.ca www.chiropractic.on.ca