Understanding Alberta massage therapy claims

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Do you have plan members who live in Alberta with Extended Health Care coverage that includes massage therapy? If so, you should be aware of Sun Life Financial’s criteria for determining which practitioners are eligible for massage therapy claims payment. Some Alberta plan members have raised questions about Sun Life Financial’s handling of these claims.

Sun Life Financial’s criteria for determining whether a massage therapist is an eligible practitioner have not changed. What has changed:

  • our increased focus on provider management; and
  • our increased controls in managing benefits claims.

Our plan sponsors expect that Sun Life Financial will help them manage ever rising claims costs. So, we have focused more on the service provider management aspect. Having better provider management controls in place results in greater accuracy in the claims payment and cost management processes, as well as better helps to protect against fraud.

Recognized / Regulated practitioners

Some paramedical professions are not provincially regulated – such as massage therapy in Alberta. This means that some practitioners’ services may be ineligible under your Sun Life Financial Group Benefits plan because the practitioners do not meet our specific criteria.

In provinces where massage therapy is regulated by the government, the qualifications that massage therapists must meet are stringent for the protection of the public. While insurance providers set their own policy for provinces where professions like massage therapy are not regulated, it is becoming more of an industry practice to set certain requirements at a level comparable to those practitioners who are licensed in regulated provinces.

For more information about the eligibility of massage therapy in Alberta, please refer to the plan member communication in the link below.

Alberta plan members who may be affected

Sun Life Financial understands that some Alberta plan members may experience issues with the eligibility of their massage therapy claims. In some cases, where a plan member’s current practitioner does not meet our eligibility requirements, a plan member may elect to change massage therapists in order to make their claim eligible under their plan. We regret any inconvenience this might cause, but we are committed to promoting a high level of quality of treatment that plan members receive as well as ensuring that massage therapy claims costs are managed appropriately and accurately.

Next Steps

We encourage you to share this communication with your plan members so they can better understand how massage therapy claims are handled in Alberta.

Questions?

Please contact your Sun Life Financial group benefits representative.