Does insurance cover massage in Ontario? OHIP doesn’t, but most extended health benefit plans do, provided the treatment is given by a Registered Massage Therapist (RMT). How much your plan pays, and what it asks of you first, varies from one plan to the next, so a few minutes with your benefits booklet before you book can save you a surprise at the front desk.
Where massage coverage comes from
OHIP, Ontario’s public health plan, pays for many medical services, but massage therapy isn’t one of them. Coverage for massage comes from extended health benefits instead. For many people that means a group plan through an employer or union, and massage therapy is included in most employee group benefit plans. If you don’t have workplace benefits, an individual plan you buy yourself may include it too. Either way, how much you can claim is set by the plan.
A health spending account is another route. Some employers offer one alongside, or instead of, a traditional plan, and it may be usable for RMT massage; each account has its own rules, so check what yours allows. If you’re covered by two plans, for example your own and a spouse’s, you may be able to claim the balance the first plan doesn’t pay from the second. This is called coordination of benefits, and both insurers can tell you how they handle it.
Why it has to be an RMT
Insurers generally cover massage only when it is given by a Registered Massage Therapist, a professional on the register of Ontario’s regulator, the College of Massage Therapists of Ontario (CMTO). In Ontario, Registered Massage Therapist and RMT are protected titles. To use them, a therapist completes an approved massage therapy program, meets the College’s entry requirements and registers with CMTO, then follows its standards: taking your health history, assessing you, asking for your consent, draping you properly and keeping a record of each treatment.
That’s why the receipt matters. A receipt from an RMT shows the therapist’s registration number, so your insurer can see the treatment came from a registered professional. A massage at a spa or salon from someone who isn’t an RMT isn’t regulated the same way and won’t be covered, however good it feels. For insurance, what generally counts is who gives the massage, not the technique. Our guide to RMT vs relaxation massage explains the difference in more detail.
Questions to ask your plan
No two plans are quite alike, so the most reliable answers come from your own. Your benefits booklet or your insurer’s member website usually spells out the details, and your insurer can confirm them by phone. If your plan comes through work, your HR team or plan administrator can help too. These are the questions worth asking before your first appointment:
- Is massage therapy by an RMT included?
- What is my yearly maximum, and how much is left?
- Is there a limit per visit, or on the number of visits?
- What share of each visit does the plan reimburse?
- Do I need a doctor’s referral first?
- When does my benefit year reset?
When your benefit year resets
That last question matters more than many people expect. Some plans reset with the calendar year on January 1, while others follow a plan year that starts on a different date. Massage benefits generally don’t carry over, so whatever is left when your year resets is lost. If a sore lower back or stiff shoulders have been on your list for a while, knowing your reset date lets you spread sessions through the year instead of squeezing them into the last few weeks.
Pay-and-claim or direct billing
There are two ways a massage claim usually reaches your insurer. With pay-and-claim, you pay for the whole session at the clinic, keep the receipt with your RMT’s registration number on it, and submit it to your insurer yourself. The insurer then reimburses whatever your plan covers. It doesn’t depend on the clinic billing your insurer, but you pay the full amount up front, and the paperwork is yours to handle.
With direct billing, the clinic sends the claim to your insurer for you, and you pay only the part your plan doesn’t cover, which, depending on your plan, can mean little or nothing out of pocket. Not every clinic bills every insurer, so ask before you book. Either way, have your benefits card handy, along with your plan member number and your policy or group number, and if your plan needs a doctor’s referral, have that ready too.
Using your benefits at Mica in Vaughan
Mica Spa + Wellness in Concord offers RMT massage in Vaughan in 45-, 60- and 90-minute sessions. If your insurer participates, we send the claim from the clinic on your behalf, so you don’t have to submit it yourself. You’ll find the insurers we bill directly on our direct billing page. If yours isn’t listed, give us a call at 905-605-8663 and we’ll check for you.
Since insurance pays only for massage by an RMT, book the RMT massage listing if you plan to use your benefits. Our Swedish and hot stone listings aren’t claimable, though your RMT may still draw on either technique during the session. Facials, laser and wrinkle treatments aren’t covered either. The clinic is at Unit 8, 20 Jacob Keffer Pkwy, just east of Keele and close to Rutherford Road, with free parking on site. We’re open seven days a week, and weekday evenings until 8 pm leave room for a session after work.
Questions, answered
Is deep tissue massage covered by insurance?
It can be, when an RMT gives it. Plans generally look at who provides the massage rather than the technique, so a deep tissue session with an RMT is claimed like any other RMT massage, within your plan’s limits.
How much will my insurance pay for a massage?
That depends on your plan. Each plan sets its own yearly maximum, per-visit limit and reimbursement level, so your insurer, benefits booklet or member website is the place to find your figure.
Do I need a doctor’s referral for massage to be covered?
Some plans ask for one and others don’t, so check yours before your first visit. You can book an RMT without a referral; it only matters if your insurer requires it to pay the claim.
How do I claim a massage through my health insurance?
Ask your RMT for a receipt showing their registration number and submit it to your insurer, or book with a clinic that bills your insurer directly and let them send the claim. If you have a second plan, you may be able to claim the remaining balance there.
Can I use my benefits for a relaxation massage at a spa?
Only if a Registered Massage Therapist gives it. A massage from someone who isn’t an RMT isn’t covered, wherever it takes place, so ask for an RMT when you book if you plan to claim.