Common questions about coverage
What are ‘paramedical’ expenses, and how are they different than ‘medical’ expenses?
Paramedical expenses are medical services or products received from a licensed medical professional who is not a medical doctor or a nurse. Examples of paramedical practitioners include acupuncturists, chiropractors, massage therapists, physiotherapists, podiatrists,
You’ll find your paramedical coverage information under ‘Paramedical Services’ list in the ‘Medical’ section of your coverage details.
How can I find out if there is a maximum number of covered visits, or any other limits, for my service?
There may be some limits that apply to your coverage, such as a maximum limit to the number of visits you’re covered for any treatment or service. If any coverage limits apply to you, you’ll find them under the ‘Limits’ section of your coverage details.
What’s an R&C (reasonable and customary) limit?
A reasonable and customary limit is the amount of money that Sun Life (or another insurance company) chooses as the normal range of payment for a specific health-related service or medical procedure. You can think of it as a ‘going rate’ in the market, because it reflects the average cost associated with a service or product in a particular region.
Here’s an example. Let’s suppose you’re going for a massage that costs $130, but Sun Life’s R&C amount is $100. Your workplace plan also allows for 80% coverage of your massage therapy treatments. This means that after you submit your claim, you’ll receive 80% of the R&C amount, which would be $80 in this scenario.
It’s important to know how much is covered under your benefits plan (and how much you may be responsible for paying out-of-pocket). That way you can minimize unexpected expenses and avoid disappointment.
