Paramedical Providers
Chiropractor
What is covered?
- 100% of the reasonable and customary (R&C) limit, up to $500 every calendar year (January 1 to December 31)
What is not covered?
- Herbal medications, remedies, supplies and vitamins
- Insurance form completion charges
- Missed appointment charges
- Motor vehicle accident-related treatments
- Occupational disease or injury-related treatments
- X-rays
This service is covered for in-person or virtual appointments.
Ask your provider if they can submit your claim directly to GreenShield to minimize your out-of-pocket costs at your appointment.
Reasonable and customary (R&C) limit for chiropractors
To ensure members are not overcharged, every year GreenShield sets a reasonable and customary (R&C) limit for the cost of a visit for chiropractor treatments and services. Every time you visit the chiropractor, the R&C limit is applied.
However…
Some providers charge more than the R&C limit.
And…
The R&C limit is the maximum amount your plan will cover for chiropractor services.
That means…
If your provider charges more than the R&C limit, you will have to pay the remaining amount out of your own pocket.
You can check your eligibility and coverage limits by logging in to your account at greenshield.ca, emailing GreenShield at customer.service@greenshield.ca or by calling GreenShield at 1-877-266-5494 to use their interactive voice system. You will then see if your estimated payments are fully covered or not.
For Example:
Gord’s chiropractor charges $170 for each visit. The R&C limit at the time for this service is $150, which is the maximum amount your plan will pay.
Since Gord will be $20 out of pocket, he has two choices:
- Pay the remaining $20 out of pocket; OR
- Use his Health Care Spending Account (HCSA) to help cover his cost—in full or in part.
Your coverage maximum resets every year on January 1.
If you reach the chiropractor plan maximum partway through the year, the full coverage amount will again be available to you on January 1.
For Example:
Don visits his chiropractor to help manage his back pain. Last year, he submitted these claims:
Don reached the annual maximum at the end of July. He then had three choices:
- Continue to schedule chiropractor appointments and pay out of pocket for the remainder of the year (until December 31); OR
- Continue to schedule chiropractor appointments and use his Health Care Spending Account (HCSA) to help cover his cost—in full or in part; OR
- Wait until his coverage maximum refreshes on January 1, and begin chiropractor visits again.
