Chiropractic Insurance Coverage

What is covered?

If you are in a car accident your auto insurance covers you for a minimum of 10 chiropractic treatments for minor injuries under the Alberta Diagnostic Treatment Protocols Regulation.

Chiropractic treatment for minor injuries is billed directly to your insurance company. You do not have to submit receipts for reimbursement. If you have been in an auto accident your chiropractor should be informed so that they can fill out the forms to have your treatment costs covered.

Through a different automobile insurance program, every Albertan is entitled to $1,000 of chiropractic care coverage for motor vehicle accident injuries (under Section B).

How do I receive treatment?

Within 10 days of the collision:

1. File an injury accident report with the police.
2. Seek treatment from a primary health care provider (PHCP): chiropractor, physical therapist or physician. If your injury is considered minor (i.e. sprain, strain or minor whiplash injury), you do not need authorization from your insurer. You may begin treatment immediately and your insurance company will be billed directly.
3. File the appropriate forms with your insurer. Forms are available from your chiropractor, insurer or insurance broker.
4. If you have any questions, please contact your auto insurance company and ask about your MVA health care coverage under Section B.

Pamphlets for your glovebox

After a motor vehicle collision, there are many important things to do – but most important of all is ensuring you receive the care you need. The handout and brochure below will walk you through the steps of receiving care after a motor vehicle accident. Print them and keep them in your glovebox for reference.

• Download the Brochure
• Download the Handout

To apply for a parking placard, click here.

What is covered?

If you are hurt at work, you can go straight to an authorized chiropractor for treatment. The WCB does not require you to see a medical doctor first.

A chiropractor can submit assessment information to the WCB for review and to determine if your claim has been accepted. For information on how to access WCB coverage or to find a WCB-authorized chiropractor, visit the WCB website.

Why chiropractic for work injuries?

Chiropractic treatment has well-documented high patient satisfaction rates among injured workers.

Chiropractic is demonstrated to be one of the most clinically and cost-effective methods of treating many work-related injuries.

To apply for a parking placard, click here.

Coverage for seniors health benefit plan

The Government of Alberta provides premium-free Alberta Blue Cross coverage to seniors for health-related services not covered under the Alberta health care insurance plan.

More than 90% of Alberta seniors are already enrolled in this plan (also referred to as Group 66). This coverage is available to all Albertans and their eligible dependents 65 years of age and older.

As announced in Budget 2019, the Government of Alberta will no longer provide benefits through the Coverage for Seniors plan for seniors' family members (such as spouses and dependents) who are younger than 65 years of age. This change came into effect March 1, 2020.

For seniors who are enrolled in the plan and need a card, please contact Alberta Blue Cross:

• 780.498.8000 (Edmonton and area)
• 403.234.9666 (Calgary and area)
• 1.800.661.6995 (toll-free)
• e-mail via www.ab.bluecross.ca

Details

Alberta seniors have access to funding support for chiropractic services under the government-sponsored Coverage for Seniors health benefit plan.

Alberta seniors have access to an annual maximum of $200 per member every benefit year (July 1 to June 30) for chiropractic services. There is a per-visit limit of $25 and all services must be performed by a registered chiropractor.

Seniors who are not enrolled in the plan should contact Alberta Health Care for chiropractic coverage options

• 780.427.1432 (Edmonton and area)
• toll-free for the rest of Alberta to 310-0000 and then 780-427-1432
• dial 711 for TTY for the deaf and hard of hearing
• e-mail via [email protected]

To apply for a parking placard, click here.

Do students have access to chiropractic treatment

Most student health-care plans cover chiropractic treatment! Chiropractors are often grouped under the “health practitioners” or “paramedical services” sections.

You can find out details about your coverage through mystudentplan or, if you attend one of the major Alberta post-secondary institutions, through the links below.

Personal benefits

• Personal benefits cover specific needs over and above your monthly living allowance.
• They may be covered for you and your dependent children.
• Some personal benefits may need to be repaid.

To be eligible, you must:

• have no more than $5,000 in non-exempt assets such as cash, investments and bonds, or be in a financial hardship situation
• demonstrate a need for the benefit
• not be eligible under any other program or source, and
• meet the specific requirements for each personal benefit

Types of benefits

There are 3 kinds of personal benefits you may get through AISH:

Health-related personal benefits

You may get help with costs for health-related supports such as:

• arch supports or foot orthotics
• continuous positive airway pressure (CPAP) device and supplies
• equipment maintenance for wheelchairs and scooters
• health services such as acupuncture, chiropractic, massage therapy and physiotherapy
• hearing aid batteries
• medical alert service
• medical equipment not available through the Aids to Daily Living program or other sources such as private insurance or temporary equipment loan programs
• medical supplies not available from the AADL program or other sources such as private insurance, home care or wound clinics
• nebulizer and supplies
• oxygen supplies
• seasonal affective disorder (SAD) light
• service animal supports
• specialized clothing adapted for a disability
• special diets
• splints and braces
• transcutaneous electrical nerve stimulation (TENS) machine and supplies

Personal benefits for children

Some costs may be covered for infant and child care or children’s education.

Other personal benefits

You may get help with costs for:

• dealing with an emergency situation beyond your control that puts you or your dependents at immediate risk
• leaving an abusive home
• employment and training expenses
• funeral arrangements
• maintaining your home in a remote community
• moving to set up a new home
• travelling for health-related services, court attendance and training

To learn more visit: What you get with AISH | Alberta.ca or see Your Guide to AISH and the AISH Financial Benefits Summary for more details about personal benefits and the costs AISH may cover.

Connect with an AISH office:

Hours: Unless otherwise noted, AISH office hours are from 8:15 am to 4:30 pm, Monday to Friday. Offices are closed on statutory holidays.
Toll free: 310-0000 before the phone number (in Alberta)
TTY: 780-427-9999
Toll free TTY: 1-800-232-7215

Chiropractors are recognized under the Health Practitioner Benefits for outpatient services. Services can be accessed only when prescribed by the attending physician, nurse practitioner or physiotherapist.

Members of the CF can access up to 10 appointments and one assessment. Acupuncture, when in conjunction with pain management, can also be applied to up to 10 treatments. Physicians can authorize attendance as indicated, per medical condition, after which physician follow-up of each case is required to ensure that care is progressing and to determine whether further care is required.

While patient care, rather than monetary limits per se, will be the determining factor, permission must be granted in advance of additional treatments/therapies. It is important to note that it is the onus of the service personnel to get pre-authorization for chiropractic services. The client then is responsible for bringing the forms to his or her Medical Officer and receiving reimbursement directly. Either way, payment should be received directly from the military person being treated.

First Nations Non-Insured Health Benefits (FNIHB) clients obtain insured services, including chiropractic services, through existing provincial and territorial plans. In some cases, where there are co-payment requirements, FNIHB clients may be eligible for chiropractic co-payment costs.

Each Health Canada region has implemented local policies, which change from year to year, regarding chiropractic coverage.

Under a decentralized management system, each FNIHB regional office (one per province and territory, except for Atlantic Canada where there is one office for the region) has the flexibility and authority to establish its own policies based on regional needs and desires.

Please contact your local provincial FNIHB branch for the most recent information:

Health Canada First Nations and Inuit Health Branch
9700 Jasper Avenue Suite 730, Canada Place
Edmonton, Alberta
T5J 4C3
1-800-232-7301
(780) 495-2694

Medavie Blue Cross administers the Federal Health Claims Processing System (FHCPS) on behalf of Veterans Affairs Canada (VAC), the Canadian Forces (CF) and the Royal Canadian Mounted Police (RCMP).

Each Blue Cross plan is responsible for answering provider inquiries in their province or region as they relate to provider services under FHCPS, including provider registration, claims payment, communication materials and the Point of Service (POS) system.

Medavie Blue Cross
Federally Administered Programs
644 Main Street
PO Box 220
Moncton, New Brunswick
E1C 8L3
Phone: 1-888-261-4033
Fax: 506-867-4651
Email: [email protected]

The RCMP policy currently in effect was published in January 2014. Dr. Eric Jackson, convener of the CCA-appointed national assessors, has been working to establish chiropractors as entrenched team members in the various regional health teams. Members can access one or all of these services – acupuncture, chiropractic, massage therapy and physiotherapy – up to a combined maximum allowance years. Preauthorization is not required; however, a prescription for acupuncture and massage therapy is required.

A Provider Claim Form should be completed. More information can be found at medavie.bluecross.ca or by calling 1-888-261-4033.

Veterans Affairs Canada offers health care benefits to eligible veterans under 14 Programs of Choice (POC). Chiropractic services are included among the “Related Health Services” under POC 12.

Medavie Blue Cross of Canada administers the payment for treatment benefits through the Treatment Accounts Procession System (TAPS). Health identification cards identifying eligibility for services and benefits are issued to clients and must be presented to registered providers.

• Group A clients are veterans and civilians who have been granted a pension from Veterans Affairs Canada.
• Group B clients are veterans and civilians who are receiving an allowance under the War Veterans Allowance Act. As of December 2011, Veterans Affairs Canada has set the frequency limit at 20 sessions per calendar year for chiropractic services.

If the Veterans’ treatment plan requires more than 20 sessions per calendar year, practitioners should contact the VAC Treatment Authorization Centre at 1-888-261-4033 to obtain approval for extended sessions.