How Extended Medical Benefits Work

When you’re ready to begin counselling, one of the first practical steps is figuring out how to pay for it. For many, that means checking in with your insurance provider. While this can feel confusing or even a bit intimidating, understanding your coverage upfront can make the process smoother, more affordable, and much less stressful. This guide will walk you through everything you need to know—so you can focus on healing, not paperwork.

Why Insurance Coverage Matters

• Financial clarity. Counselling sessions can be a significant investment—understanding your coverage prevents surprises and helps you budget effectively.
• More access to care. Many individuals delay or skip therapy due to cost concerns. With insurance coverage, professional support becomes more accessible.
• Peace of mind. Knowing your benefits helps you feel secure in your investment in therapy, allowing you to dive into the healing process with less financial stress.

Insurance Terms (Made Simple)

These are some words you might hear when talking to your insurance provider:

• Deductible – The amount you have to pay yourself before your insurance starts helping.
• Co-insurance – After your deductible is paid, this is the part you still pay (like 20% of each session).
• Copay – A fixed amount you pay each time you see your therapist (e.g., $30 per session).
• In-network vs. Out-of-network – Some plans want you to choose from a list of approved therapists (in-network). Others let you pick whoever you want.
• Pre-authorization – Some plans need you to get permission before starting therapy.

Step-by-Step: How to Check Your Coverage

Step 1: Grab Your Insurance Card

Look for your member ID, group number (if you have one), and phone number for benefits. Sometimes there’s a separate number for mental health services.

Step 2: Call Your Insurance Company

You could say something like:

“Hi! I’m looking into counselling, and I want to check what’s covered under my plan. Can you tell me if sessions with a Registered Clinical Counsellor, Registered Clinical Social Worker, or Registered Psychologist are covered?”

Then ask:

• How much is covered per session or per year?
• Is there a deductible I need to meet first?
• What’s my copay or co-insurance?
• Is there a limit to the number of sessions?
• Can I work with any provider, or only in-network?

Step 3: Chat With our Admin

Once you know what’s covered, ask admin:

• Is my counsellor eligible under my plan?
• Can you directly bill my insurance?
• If not, can you give me a receipt for reimbursement?

Who We Can Direct Bill For

Let’s break it down by professional designation:

If You’re Seeing a Registered Clinical Counsellor (RCC)

We can usually bill directly to:

• Greenshield
• Manulife Financial 
• Maximum Benefit
• Beneva
• Equitable Life
• Chambers of Commerce Group Insurance
• People Corporation
• First Canadian Insurance
• Johnston Group
• TELUS AdjudiCare
• Industrial Alliance 
• Medavie Blue Cross 
• Pacific Blue Cross

If You’re Seeing a Registered Clinical Social Worker (RSW)

All of the above, plus:

• Canada Life
• Canada Life PSHCP
• Desjardins
• Coughlin & Associates Ltd.

If You’re Seeing a Registered Psychologist

All of the above, and also:

• GroupHEALTH

What About Sun Life Financial?

Sun Life doesn’t currently allow any direct billing for mental health services. But don’t worry! You can still submit it to Sun Life for reimbursement

Direct Billing vs. Reimbursement—What’s the Difference?

Direct Billing:

• We send the claim directly to your insurer
• You pay only what’s not covered

Reimbursement:

• You pay us first
• We give you a receipt
• You submit the claim, and your insurer pays you back for your covered amount

We support both, and we’ll walk you through it either way.

What Insurance Might Not Cover

Even with coverage, your plan might have limits like:

• An annual cap (e.g. $500 or $1,200/year)
• A per-session max reimbursement (e.g. $90/session)
• A limit on the number of sessions

Quick FAQs

Do I need a referral?

No. You can just book an appointment

Can I switch therapists?

Yes! As long as your new therapist is eligible under your plan.

What if my job or benefits change mid-year?

Let us know—we’ll help you navigate the transition.

How We’ve Got Your Back

We know that figuring out insurance isn’t the most fun part of starting therapy. That’s why we make it as easy as possible:

✅ Straightforward fees and billing 

✅ Direct billing for many plans 

✅ Help with receipts 

✅ Support if you need to switch therapists or plans 

Ready to Get Started?

If you’re ready for counselling but still have insurance questions, we can help.

Call us at 604-229-4887 or email us at info@lovethistherapy.com with your plan info.