EMDR therapy is covered by most extended health insurance plans in Alberta when a registered psychologist provides it, usually up to an annual maximum of $500-$2,000 per year. Coverage is varied significantly between employers and insurance providers; pre-authorization is required by some plans while direct billing is allowed by others. Your specific benefits booklet should be checked, or your provider contacted directly to understand your coverage limits.
Fast Facts:
- Extended health benefits that include psychological services are held by roughly 70% of Alberta employees
- Annual coverage limits are typically ranged from $500 to $2,000 for mental health services
- Direct billing is made available with many Alberta psychologists, eliminating upfront costs
- Referrals from family doctors are required by some plans before therapy sessions are covered
- Coverage is often extended to family members under the same plan
Understanding Your Extended Health Benefits
Mental health coverage is typically included in extended health insurance plans in Alberta, but the details matter more than you’d expect. Between $500 and $2,000 annually for psychological services is allocated by most workplace plans. The coverage percentage varies too; 80% of costs are covered by some plans, while others go up to 100% within your limits.
Her plan covered $1,500 per year at 100%; a Calgary teacher recently discovered this. EMDR therapy had been put off for months, thinking it wasn’t affordable. Her first session was booked after one phone call to her benefits provider.
Direct Billing Makes Treatment Accessible
Direct billing arrangements with major insurance providers are now offered by many Alberta psychologists. This means only the difference between your therapist’s fees and your coverage amount needs to be paid. No upfront payments, no waiting for reimbursements.
The process is handled between your therapist’s office and your insurance company. Your benefits card will need to be provided and sometimes a signed authorization form. Standard practice at most psychology clinics across the province has become this approach, to be fair.
Pre-Authorization Requirements
Pre-authorization before covering EMDR therapy is required by some insurance plans. A brief form from your family doctor or the psychologist explaining why treatment is necessary is usually involved. The approval process typically takes 3-5 business days.
This requirement isn’t held by all plans. Treatment can be started immediately and claims submitted afterward; many allow this. Which category your plan falls into can be clarified by your benefits provider.
Coverage for Family Members
Psychological services coverage to spouses and dependent children is often extended by extended health plans. His family coverage was used by a first responder in Calgary to get EMDR therapy for his teenage daughter after a car accident. The same annual limits applied, but accessing treatment without additional insurance costs was made possible.
Family coverage details are varied between plans. Separate limits for each family member are held by some, while one annual maximum across the entire family is shared by others.
Alternative Coverage Options
If extended health benefits aren’t offered by your workplace, I suppose private insurance plans are available through companies like Blue Cross Alberta or Manulife. These plans typically cost $50-150 monthly for individuals; psychological services coverage is included.
Group insurance plans to members are also offered by some professional associations. Competitive rates through their unions or professional bodies are often accessed by teachers, nurses, and other professionals.
Making the Most of Your Benefits
Your therapy sessions can be planned around your benefit year to help maximize coverage. Many plans are reset in January, though different schedules based on your employer’s fiscal year are followed by some.
Detailed records of all therapy expenses should be kept, even with direct billing. Tax deductions may apply for medical expenses that exceed certain thresholds. Plus, documentation helps if coverage decisions need to be appealed.
Ready to explore your EMDR therapy options? Our website can be visited to learn more about insurance-friendly treatment approaches and direct billing arrangements.
Mini-FAQ:
Q: Does Alberta Health Care cover EMDR therapy? EMDR or other psychological services aren’t covered by basic Alberta Health Care. Extended health benefits through work or private insurance will be needed. That still surprises people.
Q – Will my workplace benefits cover the full cost? Look, a portion up to annual limits is covered by most plans. Common coverage ranges from 80-100% of fees up to your yearly maximum. Your benefits booklet should be checked for specifics.
Q: Can I get reimbursed if I pay upfront? Fair point. Reimbursement is allowed by most insurance plans if receipts are submitted. Direct billing is also offered by many therapists, so only the difference needs to be paid.
Q: What if my therapist isn’t a psychologist? Your plan’s definitions determine coverage. Social workers or counsellors are covered by some, while only registered psychologists are covered by others. Worth checking before booking.
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