New to Canada? How to use health insurance from work

Your work benefits and provincial health card are different

Your employer may call the plan group benefits, extended health benefits or workplace health insurance. It may help pay for services such as physiotherapy, massage therapy, prescriptions or dental care, depending on the plan.

This is separate from your province's public health coverage, such as MSP in BC. Ask HR which plan you have and whether provincial enrolment is required for your workplace coverage. Do not assume an ordinary extended health plan covers a gap while you wait for provincial coverage.

You may see a benefits deduction on your payslip. That is a contribution toward the plan's cost, not a personal balance that you can withdraw.

Sources: Government of Canada: other types of health insurance for newcomers; Canada Life: how employee benefits work.

1. Find your plan and confirm it is active

Ask your HR team or benefits administrator for:

• The insurer or benefits provider's name and the official member website or app.
• Your group or policy number and your member or certificate number.
• The date your coverage starts and any enrolment steps or deadlines.
• Your benefits booklet and instructions for adding eligible dependants, if needed.

Register for the member account using the instructions provided, then connect your workplace plan. Creating a login alone does not establish that your coverage has started or that a spouse or child is enrolled.

Save your digital benefits card if one is available. It is different from your provincial health card.

Sources: Manulife: registering and enrolling in group benefits; Sun Life: finding coverage cards and submitting claims.

2. Check the service you want to book

Open the coverage or benefits section of your member account and find the service, such as physiotherapy or massage therapy. These may appear under paramedical services. Check the booklet for details that are not shown in the account summary.

For the exact appointment, find out:

• Which practitioner credentials are eligible. In BC, check whether massage coverage requires an RMT.
• Whether a doctor's referral or other approval is required.
• The percentage paid, any deductible, and any limit on the fee accepted per visit.
• The remaining benefit balance, any visit-count limit, whether the maximum applies per person or family, and whether services share it.
• When the allowance resets, and whether a displayed limit refers to eligible expenses or the amount the insurer pays.

If a term is unclear, use the insurer's member support before booking. Two people with the same insurance company can have different employer plans.

Sources: Canada Life: coverage, balances, claims and coordinating plans; Manulife: group benefits questions and terminology.

The insurance words, in plain English

• Claim: a request for the plan to pay an eligible expense.
• Reimbursement: money paid back to you after you pay for a service.
• Deductible: an amount you pay toward eligible expenses before the applicable benefit starts paying, as defined by your plan.
• Premium: the cost of having the insurance plan, paid by your employer, you, or both. It is separate from the amount you pay for an appointment.
• Reasonable and customary (R&C) limit: the amount the insurer accepts as an eligible fee for a particular service. A clinic may charge more.
• Coverage percentage: the share of an eligible expense the plan pays. A fee limit can mean it is a percentage of less than the clinic's full price.
• Annual maximum: the limit for a benefit during the plan's defined year. Confirm whether it caps eligible expenses or insurer payments, and whether other services share it.
• Remaining balance: the amount of that benefit still available. It is not a cash payout for unused benefits.

The cost examples below show how these terms affect the amount you pay.

Sources: Manulife: group benefits questions and terminology.

Find the instructions for your insurer

Select your insurer below. These are starting points from its published help instructions, checked October 12, 2026; menu labels can vary by plan and change over time. Choose the person receiving care and the exact service before reading the amounts.

The company name does not tell you how much is covered. Coverage depends on your employer's plan and the insurer's eligibility and fee rules. Compare the service rules, percentage, accepted fee, deductible and remaining balance in your own account.

Another insurer? Use the member website shown on your benefits card or ask HR for the official link. Look for the service's coverage details and remaining balance, then confirm any missing conditions with member support.

Sources: Sun Life: checking coverage on the web and mobile; Manulife: group benefits questions and terminology; Canada Life: coverage, balances, claims and coordinating plans; Pacific Blue Cross: coverage balances and claiming deadlines; GreenShield: checking coverage and eligibility; Desjardins: group plan access and insurance booklet.

Estimate what you will pay before booking

Start with the clinic's full quoted fee. Ask the insurer how much of that fee is eligible, whether a deductible remains, what percentage applies and whether your remaining allowance is enough. For these one-plan examples, your eventual cost is the clinic's fee minus the amount the plan actually pays.

The examples below all use a fictional $140 appointment and 80% coverage. They assume an eligible service and provider, one plan, no other exclusions, and no deductible unless specified.

If your employer also offers a health spending account, check its separate eligible-expense rules and available balance. It may help with some unpaid costs, but it is not automatically included in the main benefit shown above.

Plans can apply limits and deductibles differently. Pending claims or a shared benefit can also change the balance before your visit. Use the insurer's estimate for your situation rather than treating this table as a universal formula.

Cost and payment today are different. If the clinic receives payment directly, you may pay only the uncovered portion. If reimbursement goes to you, you may need to pay the full $140 first and wait for the claim payment.

The clinic quoted $[fee] for [service and duration] with [practitioner]. Under my plan, how much of that fee is eligible, what deductible and benefit limits apply, and what is my estimated reimbursement? Will payment go to me or to the clinic?

Sources: Sun Life: checking coverage on the web and mobile; TELUS Health: insurer responses and payments; Canada Life: how employee benefits work.

3. Book, and ask how payment will work

Choose a practitioner and service that meet your plan's requirements, then confirm the fee and appointment type with the clinic. For massage, our RMT credential checklist explains what to verify. For physiotherapy, see booking versus insurance referral requirements.

If the clinic offers direct billing: it submits the claim for you. Ask whether it can receive payment directly for your insurer, practitioner and service. You may still need to pay a portion or the full fee.

If you need to pay first: request an itemized receipt and submit a claim yourself. A clinic that cannot direct bill may still provide a service your plan reimburses.

Our direct-billing guide has the detailed questions to ask reception.

Sources: TELUS Health: insurer responses and payments.

4. Submit your first claim and check the result

1. Check whether the clinic has already submitted the expense.
2. If you need to submit it, sign in to your insurer's official member account and choose the claim option for the service.
3. Select the person who received the service and enter the requested practitioner, date and payment details accurately.
4. Provide the receipt or other documents when requested. Check that the receipt identifies the person treated, service date, service and practitioner, appointment duration where required, fee and payments. Set up reimbursement payment details if needed.
5. Review the claim status and payment explanation. Keep your receipt for the period your insurer requires.

If the claim is declined or pays less than expected, read the explanation before resubmitting. Ask the insurer what needs correcting or why a limit applied.

Check the submission deadline in your plan. The last day to claim an expense and the date your benefits reset are different questions.

If you are leaving your job or changing plans, ask HR for the coverage end date and ask the insurer when earlier eligible expenses must be submitted. Being able to log in does not prove a new appointment is still covered.

Sources: Canada Life: coverage, balances, claims and coordinating plans; Sun Life: finding coverage cards and submitting claims; Pacific Blue Cross: physiotherapy receipt requirements; Canada Life: how employee benefits work.

If your partner also has benefits

If you are covered by more than one plan, ask about coordination of benefits: the plans may work together to pay an eligible expense. Tell both administrators about the other coverage and confirm which plan receives the claim first.

Do not assume a partner or child is covered until their enrolment is confirmed, or submit the full expense to two plans as if the first payment had not happened.

Sources: Manulife: registering and enrolling in group benefits; Canada Life: coverage, balances, claims and coordinating plans.

A message you can send to HR

I'm new to using workplace health benefits in Canada. Could you confirm that I'm enrolled, when my coverage starts, and where I can find my benefits booklet, member numbers and insurer login? I'd also like to know how to add eligible dependants and who can help me check coverage for physiotherapy or RMT appointments.

HR can help with enrolment and plan access. Your insurer confirms how a particular expense will be covered, and the clinic confirms its services and billing process. Once those details are clear, you can use Knead to compare openings in Greater Vancouver and book with the clinic.

Sources and scope

This guide explains booking and payment questions. Your clinic confirms appointment eligibility; your insurer or Health Insurance BC confirms benefits. Sources were checked on 2026-10-12.

• Manulife: registering and enrolling in group benefits
• Canada Life: coverage, balances, claims and coordinating plans
• Government of Canada: other types of health insurance for newcomers
• Canada Life: how employee benefits work
• Sun Life: finding coverage cards and submitting claims
• Manulife: group benefits questions and terminology
• Sun Life: checking coverage on the web and mobile
• Pacific Blue Cross: coverage balances and claiming deadlines
• GreenShield: checking coverage and eligibility
• Desjardins: group plan access and insurance booklet
• TELUS Health: insurer responses and payments
• Pacific Blue Cross: physiotherapy receipt requirements