Accessing
Physiotherapy services can be accessed in a number of ways including:
- After surgery or during a hospital stay
- By a doctor's referral
- Without a referral
Coverage
- Many Albertans have physiotherapy coverage through employer or private health plans.
- There is limited coverage from Alberta Health Services.
- Treatment for workplace injury is often covered by workers’ compensation.
- Treatment for minor car accident injuries is covered and pre-approved by the individual's car insurance policy.
Hospital
In a hospital, physiotherapy is covered as part of the patient's stay. On discharge, some ongoing physiotherapy services may be provided by Alberta Health Services (AHS). For example, home care, hospital outpatient treatment - but eligibility depends upon the patient's condition.
Workplace injury
For work-related injuries, the Workers’ Compensation Board Alberta (WCB) pays for an initial physiotherapy examination and the first treatment. Further physiotherapy treatment is only approved once the claim is accepted. If approved, the WCB may authorize physiotherapy treatment for up to six weeks. The length of the treatment time varies depending upon the individual's injury. Find a WCB-approved physiotherapy clinic .
Motor vehicle accident
Benefits depend upon the type of injury. For sprains, strains or whiplash injury, physiotherapists can bill the insurer directly. For other types of injury, expenses must be submitted to the extended health benefits plan first. If the individual does not have a plan, or coverage is exhausted or does not cover all expenses, they can submit expenses to their automobile insurer. For more information, see What to do after an Auto Collision on the Government of Alberta’s website.
Other injuries or problems
For all other problems, there are three payment options depending on the individual's circumstances.
Alberta Health Services (AHS)
If the individual lives in Calgary or Edmonton the physiotherapist must determine their eligibility for funding using criteria set out by AHS. Funding in other locations varies based on priority and resources. To find AHS-funded physiotherapy services, visit Alberta Health Service’s website and search for “physiotherapy.”
Health benefit plans
Physiotherapy treatment is normally included within employer-paid or individually purchased health benefit plans. The amount of coverage and rules to access physiotherapy vary between plans. The plan will indicate if the insurance company requires a doctor's referral to have fees reimbursed.
Direct payment
Individual's not eligible for coverage outlined above and don’t have coverage under a health benefits plan, will need to pay for treatment directly.