Now You Have Health Benefits

You’ve officially locked in a full-time position in your field. You’re on salary and there’s a great benefits package. Basically, you’ve struck gold!

You’re already planning a self-care spree and you haven’t even started your new job yet — will it be monthly massages? Quarterly dental cleanings? Prescription shades? Finally, trying therapy? You’re so freakin’ elated! Anything is possible! You wonder if this is adult heaven. 

Now, fast forward a year into your new job... You haven’t claimed a single penny from insurance. You’re wondering where all the time went and how people even find the time to use benefits.

Sound familiar? We totally get it. No judgment!

In fact, you’re in the vast majority. Did you know that only 11% of people report that they’re using their benefits to the fullest? 89% of us are missing out on serious perks! 

Maximizing a benefits package can actually be worth a lot more than an equivalent salary increase

On average, employers pay an extra fifth of your salary on top of what they pay you directly in order to secure your benefits package. If you’re wishing they would just tack that on to your salary instead, slow down and consider that carefully. When you do the math, a benefits package is worth a lot more than an equivalent salary increase. But, that’s only true if you use it. 

If you do have access to benefits through your workplace, partner or parent, take this as a friendly reminder that your self-care is worth it. Don’t know where to start, who to book, or what’s covered? Read on! If you don’t have access to benefits at this time, reach out to our care coordination team to find out what options are available to you.

Here’s a crash course in using benefits for therapy.

Step 1: Figure out what you’re covered for

Benefits providers can often make it difficult to know what you’re actually covered for.

Most plans have coverage for either a Registered Social Worker (RSW) or Registered Psychotherapist (RP). Some plans might say they cover Psychologists, but often if you ask for clarity from your benefits provider they often mean Psychologist or Registered Social Worker. Sneaky.

It’s best to contact your benefits provider for clarity. Feel free to send your policy to our care team and we can help you interpret it, too!

Not sure where to look for your policy? Go to your manager, HR lead, or send a Slack message to that one colleague who knows everything and ask them where to look for details about your benefits.

Step 2: Check your coverage

You’ll typically find psychotherapy under “Extended Health Benefits” in your plan, and it may or may not be under the subheading “Paramedical Services”. There’s often a fixed amount you can spend each year in these categories (how much exactly varies plan-to-plan) and sometimes there are hoops to jump through, such as a physician referral, for example. 

It’s common that all “Paramedical Services” will draw from one pool of money. This means that if you use your benefits to see a naturopath, for example, there will be less money available for other services.

And on other policies, you’ll have a specific maximum just for therapy regardless of how much you’ve spent in other categories.

Given that you’ll have a maximum amount to spend in one way or another, it’s a wise move to get the most cost-effective yet quality possible. Psychologists, for example, far more expensive than Registered Social Workers or Registered Psychotherapists.

Step 3: Do the math      

It might say your coverage is 100% with no limit. If so, lucky you! Skip ahead to Step 4.

If instead you find yourself with something like, $100 per psychotherapy session up to $1000 per year, then it’s time to do a little simple math. Looks like you could have 10 sessions with $100 off. Easy.

Next, it’s time to consider how frequently you want to go and what you can afford. Thinking you’d like to spread out the sessions throughout the year? You could book (almost) monthly appointments. At that rate, let’s say you can budget an extra $50-100 per session out of pocket. Then you’ll have to find a therapist who charges $150-200 per session.

Going through a hard time and feel like you need to use all that therapy up as fast as you can? Go ahead and book weekly or bi-weekly sessions. If your cash flow is tight, you may need to adjust your out-of-pocket budget because you’re paying more frequently. Time to find a therapist who charges $140 or less. Getting the hang of it?

If your benefits policy doesn’t match up with your expectations, let your workplace know the coverage available to you doesn't reflect the real cost of services in your area. Your feedback could be the push needed for a package update! Also, don’t hesitate to reach out to therapy practices like ours anyway — as many therapists regularly have sliding-scale (discounted) spaces available. Just ask.  

Step 4: Find your match

Now that you have your budget and frequency figured out, it’s time to find somebody who jives with you. We often joke that finding a great therapist can feel like dating. That’s because you’re not only looking for someone that has the training and skills to support you, but also someone that you feel comfortable with.

But never fear, we’re here to help! Our care team is exceptional at helping you find your match, therapeutically speaking. Sure, you can browse our team or Psychology Today endlessly. But why not make it easier on yourself by getting a hand from our team?

We’ll ask you some basic questions about what you’re looking to work on and make some recommendations, giving you the option to book your initial session or a 15-minute meet and greet with a therapist.

And even if after your initial session you don’t feel like your therapist is great fit, we’ll give you a second session with a different therapist for free. Yes, free! We mean it when we say we have your back.

Step 5: Reimbursement plan

Unlike going to the dentist or getting a prescription, therapy practices are generally unable to bill insurance providers directly. This isn’t for lack of trying — it’s because of awkward, dated regulations that are common in most Canadian provinces.  

Having said that, it doesn’t hurt to ask when you book your initial session if you pay after the session or if the practice bills your insurer.      

At our clinic, we provide an automatic email receipt to you as soon as your session is over with all the information on it that you’ll need to claim your session with your insurer. Benefits companies like Manulife, for example, typically reimburse you within several business days.  

Always ask questions! Most insurers have a 24-hour phone line that you can call to clarify something if you’re unsure about the fine print. And if you’re wondering about a service, check in with the care coordinator or practitioner at the place you’re looking to book. They’ll be happy to assist you as long as it’s before the day of your appointment. Remember: If you find out your insurer does not cover a service that already happened, you are on the hook to pay for it!

‍Step 6: Give it a shot          

Many of us putting off therapy because we’re not “bad enough”, or we tell ourselves that other people may have it worse than we do.

However, there’s no such thing as being “bad enough” to try therapy. Therapy is a good thing anytime. Why? Because therapy isn’t only about dealing with life’s challenges, it’s also about building positive habits and resiliency when things are going well.

So give it a shot. We’re here to help you every step of the way.  

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This article was written by Seamus Ogden during their time at Shift Collab.