Shifting the way we use our benefits: prevention rather than reactive care

There is a new trend in health care: avoiding illness and injury through self-care and preventative maintenance.

Over 80% of Canadians have some form of extended health care coverage, but often don’t fully utilize them.

Why? There are many reasons, from being too busy to not wanting to waste them now in case we need them later.

Perhaps we need to shift how we view benefits to be a way of avoiding illness and injury by having regular check-ups as a means of staying strong and healthy rather than recovering.

On average, those with extended benefits have 80% coverage of a minimum $500 per year per person for each paramedical service including Massage Therapy and Physiotherapy. That averages out to eight Physiotherapy treatments and five Massage Therapy treatments each year. It is reported by many insurance providers that on average, less than 40% of people exhaust their benefits.

So how can you optimize your benefits to enhance your health and wellbeing?

  1. Know your benefits plan:

Work out your eligibility. What is your maximum allowance? How many appointments does that work out to within a year? Once you know this you can create your health maintenance plan.

  1. Make a plan:

Plan out how you are going to use your benefits. Do you want to prevent injury from occurring the best you can? Look at the providers you have access to and set yourself a schedule of appointments to see those practitioners throughout the year so that you fully maximize on your benefits.

Are you conservative – a “what if” person? Set a date in the year, for example June 30th, and assess whether or not you have needed to use your benefits due to injury. If not, then create a plan to utilize your benefits so that you don’t get to December 1st and try and cram in an appointment every other day at the busiest time of year.

  1. Take advantage of benefits that will disappear or be reduced next year:

Read the information your employer gave you at the beginning of the year. Carefully review the information about your insurance benefits, and see if any benefits are being cut or reduced in next year. If so, will you be affected by the changes? Get the most out of your coverage now before the cost of your treatment goes up.

  1. Look at how you can optimize on coordination of benefits:

Sometimes you might have benefit coverage under more than one extended health plan or even more than one health benefits provider. For example, your plan might be through Pacific Blue Cross and your spouse’s plan through Sunlife.

In these cases, the patient can submit the expense under both plans to get up to 100% of their expense covered. This is called coordination of benefits.

With coordination of benefits, you claim first with the plan you are a member of, then you claim any amount that was not reimbursed with the second plan.

If you and your spouse both pay premiums to participate in a benefit plan, you may be tempted to save on payroll deductions by opting out of the plan that pays the smaller percentage. However coordinating the benefits provided by each plan can save you money, in most cases providing coverage up to 100% of the expense. Saving you from out-of-pocket expenses related to health care cost is what your benefit plan is supposed to do.

  1. Find a provider that can direct bill:

Reduce your out of pocket expenses by using a provider that is able to direct bill to your insurance company. At Back in Action we are able to direct bill to 12 insurance providers. You can do this for both Physiotherapy and Massage Therapy.

The New Year is usually a time when many of us make resolutions, usually related to our health.  Now is a good time to start looking into how you can best manage your benefits plan.