Private health insurance: Does your client still need a doctor's note for reimbursement?

Private health insurance: Does your client still need a doctor’s note for reimbursement? | Insurance Business Canada

Life & Health

Private health insurance: Does your client still need a doctor’s note for reimbursement?

Policyholders urged to confirm with their carriers

Life & Health

By
Terry Gangcuangco

Private health insurance policyholders in Nova Scotia are advised to confirm with their insurers whether a doctor’s note is still required for services such as massages, physiotherapy, or chiropractic care in a bid to help free up doctors’ time.

CBC News cited the Department of Health and Wellness as previously saying that fewer than 10% of private health insurance plans in the province require a referral for those services.

In a recent confirmation, the department shared with CBC News that the information was sourced from the Canadian Life and Health Insurance Association (CLHIA). A department spokesperson explained that the shift away from requiring a doctor’s referral for reimbursement is in line with best practices for insurers.

CLHIA group benefits vice president Joan Weir commented: “Our impression is there’s a real misunderstanding out there on behalf of patients and perhaps on behalf of prescribers and physicians that everybody needs a referral, and that’s simply not true.”

According to Weir, data from CLHIA member companies shows that only 3% to 18% of insurers or employer groups still mandate referral notes.

She added: “Most people who have private benefits through an employer will have a portal that they can log into and access the information as to whether a referral is required. And if in doubt, go to your employer and ask, because they will for sure know.”

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