What Changed in 2025? New Insurance Rules for Massage & Wellness
Introduction: A New Year, New Insurance Rules — Are You Ready?
If you’re heading into 2025 assuming everything about your benefits will stay the same — stop right there.
Over the past few months, we’ve seen quiet but significant updates across Canada’s largest private health insurers. From predetermination requirements to changes in maximums and eligible providers, the rules for accessing massage therapy, chiropractic, and other wellness services are shifting.
This article will walk you through the top 5 changes you need to know to avoid claim denials, coverage gaps — and missed opportunities.
🔁 1. More Plans Now Require Predetermination for RMT
As insurers work to reduce fraudulent or excessive claims, predetermination (pre-approval) is becoming more common — especially for:
- High-volume treatment plans (10+ sessions)
- Claims over $500 per service type
- First-time users of extended benefits
What to do:
✅ Ask your RMT clinic to submit a predetermination form
✅ Expect 5–10 business days for insurer approval
✅ Don’t book until coverage is confirmed — or risk paying out of pocket
💬 Need help? Ask Ruby at insurance.rmtclinic.online
🧾 2. Insurance Receipts Now Require Tighter Formatting
Insurers like Manulife and Canada Life have tightened receipt requirements. Missing any one of the following could now void your claim:
| Required Field | Must Include |
| RMT Name & License | Full name + registration number |
| Paid Status | “Paid in Full” or equivalent |
| Breakdown | Service, duration, fee, date |
| Clinic Info | Address, contact, GST/HST where applicable |
| Patient Name | Match to the insured member or dependent |
💡 Pro tip: Ask your provider to issue standardized e-receipts or use clinics listed on RMTClinic.net that meet insurance-ready formatting.
📉 3. Some Annual Maximums Were Lowered for Wellness Services
In 2025, some insurers have adjusted maximums — often silently.
| Provider | Service Affected | Old Max | New Max |
| Manulife | Massage Therapy | $800 | $600 |
| Sun Life | Physiotherapy | $1,200 | $900 |
| Greenshield | Chiropractic | $500 | $400 |
If you’re counting on the same limits as last year, check again.
✅ Log into your insurer portal or ask your HR rep
✅ Ruby can help you estimate what’s left on your plan
🧑⚕️ 4. “Virtual” Services Have New Restrictions
During the pandemic, virtual physiotherapy, chiropractic consultations, and even mental health sessions were allowed — sometimes without direct provider contact.
In 2025:
- Virtual massage therapy claims are not accepted
- Virtual physiotherapy must include an approved telehealth platform
- Some mental health services now require psychologist-level credentials
📍 Want to be safe? Book in-person sessions with regulated professionals only, or confirm virtual eligibility in advance.
🔄 5. More Plans Now Coordinate Automatically with Spouse’s Insurance
Some providers are testing automatic Coordination of Benefits (COB) — meaning if you submit to your plan first, your spouse’s plan may auto-process the balance.
✅ Faster reimbursement
✅ Fewer duplicate receipts
✅ But… only if you’ve registered both plans and dependents properly
Check if your plan supports this with:
- Sun Life
- Empire Life
- GroupHEALTH
- Equitable Life
💬 Ruby can guide you through COB step-by-step at insurance.rmtclinic.online
📣 What to Do Now: Avoid Surprises in January
✅ Contact your clinic and ask if they’ve adjusted their billing practices for 2025
✅ Review your plan booklet or insurer dashboard
✅ Ask Ruby for a 2025 coverage review and booking checklist
🔗 Find insurance-eligible wellness clinics near you → RMTClinic.net
🔗 Review your new plan rules → insurance.rmtclinic.online
