Extended Health Benefits: From Workplace Perk to Essential Healthcare

Extended health benefits (EHBs) were once considered a workplace perk, but today, this significantly understates their necessity. For millions of working people and their families in Ontario, employer-sponsored EHB plans have become the access point to medically necessary physiotherapy care. Participation in rehabilitation after an injury, surgery, or accident is now often dependent on the amount of workplace-sponsored insurance coverage an individual has access to. EHBs, therefore, have become an essential part of Ontario’s healthcare system.

Benefits Fill Gaps (Partially)

The provincial government funds healthcare, but it is neither sufficient nor comprehensive enough to meet the needs of those living in Ontario. Physiotherapy care is critical for recovery from illness and injury, and yet public funding is extremely limited, with most working adults not qualifying, EHBs are now filling some of these significant health system gaps.

This reality is putting employers in a position where they are increasingly funding access to essential health services for their employees. However, for many individuals, the physiotherapy coverage provided through insurance plans is not sufficient to meet their health needs, forcing them to access other, and more costly, parts of the health care system. If reducing pressure on emergency departments and family physicians remains a health-system priority for the Government of Ontario, improved access to physiotherapy in the community is a necessity. There is a growing need for new conversations about access to care across the public system, employers and insurance providers.

Not Enough EHB Physiotherapy Coverage

For more than 30 million Canadians, physiotherapy is primarily accessed through EHBs. Most injuries and health conditions require significantly more physiotherapy care than benefit plans cover. Coverage often runs out before full recovery is achieved, forcing people to pay out-of-pocket, end treatment early, or go without necessary care. Recovery is not complete when a person’s benefits run out; it is complete when an individual can return to work, family life, and the activities that matter to them most. Function and mobility are vital signs that matter.

Increase Physiotherapy Coverage, Keep Employees Healthy

Musculoskeletal conditions remain one of the leading causes of disability and lost productivity in Ontario. Timely access to physiotherapy can help:

• restore function

• reduce pain

• reduce medication use or reliance

• and support a safe return to work

Physiotherapy matters to both workers and employers:

• For workers, it supports health, independence, and earning potential.

• For employers, it helps retain experienced staff and maintain productivity.

For many workers, access to physiotherapy care is solely dependent on an EHB package, Consider a skilled trades worker with persistent low back pain. Without access to sufficient physiotherapy care, that worker may struggle to remain on the job, requiring modified duties, extended leave, or more costly medical interventions. Keeping employees healthy and on the job simply makes sense.

EHB Plans Need More Flexibility and Increased Limits

Physiotherapists are rehabilitation experts; they are trained to assess and monitor rehabilitation care required for the recovery of musculoskeletal injuries and impairments. The challenge is that patients often reach the limits of EHBs coverage before reaching the end of their treatment plan. Ontario’s public healthcare system has increasingly come to rely on employer-sponsored plans to fund rehabilitation care, even though workplace plans were never designed to serve as a substitute for public health care. As a result, access to physiotherapy and therefore, health outcomes, can vary significantly depending on where someone works, whether they have EHBs, and how generous their coverage is. There is a clear need for employers to fully understand and assess EHB plans and whether they meet the needs of their workforce. But this is not the full story.

Not Enough Government Funded Physiotherapy Coverage

Government funding for rehabilitation, chronic disease management, and other community-based health services has become increasingly limited. Employers are now considering how to fill the gaps for their employees. However, this means that access to physiotherapy now depends on employment status, collective agreements, and insurance plan design rather than clinical need. This is a clear health equity and access concern.

End the Private/ Public Silos – Let’s Plan Together

The Ontario government funds healthcare through tax revenues, while employers (and employees) finance private healthcare access through extended health benefits. Yet these systems largely operate in silos. Employers, government, and clinicians rarely work together to determine how best to improve care for people across Ontario.

It is time for government, employers, and clinicians to come together to identify gaps in care, clarify responsibilities, and build a coordinated approach that better serves people across Ontario.

Advocating for Changes

The Government of Ontario needs to consider both the upstream and downstream impacts of limited access to physiotherapy care. There must be a reliable pathway for all people in Ontario to access essential physiotherapy following injuries, surgeries, and accidents, including collaboration with employers and insurers to ensure benefit structures reflect the true timelines of recovery. If the Government of Ontario continues to under-invest in physiotherapy, emergency departments and family physicians will remain overrun with patients seeking care for musculoskeletal injuries and impairments. Access to physiotherapy should depend on clinical need, not on whether a person has the good fortune to have EHBs. This is an equity issue which can’t be ignored.

Take Action! Complete Our Survey by November 9

OPA is exploring current trends in extended health benefits usage through private practice physiotherapy clinics in Ontario, and how these trends impact physiotherapy care and patient recovery.

This survey is for physiotherapists whose patients access care using Extended Health Benefits. It should take approximately 8-10 minutes to complete. Thank you in advance for your contribution.