Use It or Lose It: How to Use Your Benefits for Therapy Before They Reset
If your workplace benefits include coverage for psychology or psychotherapy, any amount you don't use by your plan's renewal date usually disappears. For many Ontario plans that date is December 31. To make the most of it, find out your reset date and how much coverage you have left, then book sessions now, before year-end schedules fill up.
Many people with good benefits never use their mental health coverage, often because they aren't sure what it includes or how to claim it. Here's how to figure out what you have and use it well.
1. Find out when your benefits reset
Most plans reset on January 1, but some follow a different plan year, like your employer's fiscal year or your hire date. To check:
Log in to your insurer's app or member website (for example, Sun Life, Manulife, Canada Life, Green Shield or Blue Cross).
Look in your benefits booklet for the "benefit year" or "plan year."
Ask your HR department.
2. Check exactly what's covered
Mental health coverage varies a lot from plan to plan. Look for these details:
Annual maximum: the total your plan will pay each year (for example, $500, $1,500 or more).
Per-session limit or percentage: some plans pay a set amount per visit, others pay a percentage like 80%, and others cover the full amount.
Covered providers: some plans cover only psychologists; others also cover registered psychotherapists or registered social workers. This matters when you choose a therapist. At One Psychology Clinic, every session is billed under a registered psychologist, so it can be claimed wherever your plan covers psychological services.
Referral rules: a few plans may need a doctor's referral before they'll reimburse you.
Claim deadline: many plans give you a limited time after the plan year ends to submit receipts, so don't sit on them.
Once you know your remaining balance, you can work out how many sessions it covers.
3. Don't forget your Health Spending Account
If your employer offers a Health Spending Account (HSA), you can often use it to cover what your regular plan doesn't, like the part of a session fee that's left over after insurance. Some HSAs let unused money carry forward for a year, but many don't, so check yours.
4. Combine with your partner's plan
If you're covered under a spouse's or partner's plan too, you can often claim the leftover amount from their plan after yours pays. This is called coordination of benefits, and it can make therapy close to fully covered. Submit to your own plan first, then send the remainder to theirs.
5. Check for a free Employee Assistance Program (EAP)
Many employers offer an EAP with a few free, confidential counselling sessions. It's separate from your benefits, so using it doesn't reduce your annual maximum. An EAP can be a good starting point, and your regular coverage can continue your care if you want longer-term support with a therapist you choose.
6. Keep your receipts for tax time
Fees for therapy with a psychologist, and in many cases with other regulated mental health professionals, can count as eligible medical expenses on your income tax return. Keep every receipt, including amounts your insurance didn't cover. Check the Canada Revenue Agency's list of eligible medical expenses or ask your accountant what applies to you. Psychologists are eligible practitioners under CRA.
7. Book now, not in December
November and December are busy months for therapists, because many people try to use their benefits at the last minute. Booking in October gives you time for several sessions before your coverage resets, instead of squeezing one or two in over the holidays.
It's also worth remembering that therapy works best as a steady process. Starting now gives you a real chance to make progress, and when your benefits renew in January you can simply continue.
Frequently Asked Questions
Does OHIP cover therapy with a psychologist or psychotherapist? No. OHIP doesn't cover private-practice psychologists, psychotherapists or social workers. Most people use workplace benefits, a Health Spending Account, or pay out of pocket.
Do unused therapy benefits roll over to next year? Usually not. Most plans reset your mental health maximum at the start of each plan year. Some Health Spending Accounts allow a one-year carry-forward, so check your plan.
Can my therapist bill my insurance directly? Some clinics can direct-bill certain insurers, so you only pay the portion not covered. One Psychology Clinic direct-bills most major insurance plans, as well as WSIB, NIHB and MNO. Otherwise, you pay at the appointment and submit the receipt through your insurer's app.
Will my employer know I'm seeing a therapist? Insurance claims are confidential, and your employer typically sees only overall usage for the whole company, not individual claims. If you have concerns, ask your insurer or HR about their privacy policy.
What should my receipt include? Most insurers need the therapist's name, professional designation and registration number, the date and length of the session, and the amount paid. Registered clinicians include these details on their receipts.
Ready to use your benefits?
One Psychology Clinic's team of psychologists and supervised clinicians offers therapy and assessment in midtown Toronto, at 234 Eglinton Avenue East, and online across Ontario, with daytime, evening and after-work appointments.
Every session is billed under a registered psychologist, so you can submit it to your insurance under Psychological Services. We direct-bill to many private plans, including but not limited to Sun Life, Manulife, Canada Life, Green Shield Canada, Medavie Blue Cross, Alberta Blue Cross, Desjardins, Beneva, Equitable Life, TELUS Health, Johnston Group, Johnson, Chambers Plan, CINUP, First Canadian Health, and Maximum Benefit. If you're not sure what your plan covers, our front desk can help you figure it out (email us! info@onepsychology.ca).
If you would like to get started, reach out to us and fill out the New Client Form.
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