The federal government is the fifth largest provider of healthcare services. It provides services through a variety of funding and delivery models, some of which include chiropractic services.
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 of $4,800 per calendar years. Preauthorization is not required; however, prescription for acupuncture and massage therapy is required.
A Provider Claim Form should be completed. More information can we found at medavie.bluecross.ca or by calling 1-888-261-4033.
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 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)
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
Veterans Affairs Canada
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 to 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.
Medavie Blue Cross
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