If you're thinking about an ADHD assessment for yourself or your child, cost is probably one of your first questions. And if your benefits are through Canada Life, you may be wondering whether your plan will help. The honest answer is that it depends on your plan. This guide explains how Canada Life plans usually describe psychological services, what to check and how to ask the right questions before you book.
This post is general information, not insurance or financial advice. Only your plan documents and Canada Life can confirm your coverage.
The short answer: it depends on your plan
Canada Life administers many different group benefit plans, and each employer or organization chooses what its plan includes. Two people with Canada Life benefits can have very different coverage. One plan may include psychological services with a generous maximum, while another may have a small maximum or none at all.
That's why there's no single answer to "does Canada Life cover ADHD assessments?" The only way to know is to check your own plan booklet or contact Canada Life directly. The good news is that a few targeted questions can usually get you a clear answer.
How Canada Life plans usually list psychologists
Group plans may list mental health providers together under a benefit for health practitioners or paramedical services. For example, one publicly posted Canada Life employee benefit booklet covers out-of-hospital treatment by a registered psychologist, a qualified social worker, a psychotherapist governed by a regulatory body or a registered clinical counsellor where they are provincially regulated. Another posted Canada Life enrolment guide lists "Psychologist" among its covered provider types.
Those are only examples, and your plan may be different. Notice what they mention: the type of provider, not the type of service. Neither example booklet lists ADHD assessments or psychological testing as a separate item. That means you'll need to ask whether an assessment falls under your psychologist benefit.
Shared maximums can add up fast
Some plans set one combined maximum for several types of providers. In one of the example booklets, psychologists, social workers, psychotherapists and counsellors all share a single calendar-year maximum.
This matters because an ADHD assessment usually involves several steps, from an intake and interviews to testing, a written report and a feedback session. If you or your family have already used part of your maximum on therapy this year, there may be less left for an assessment. Check how much of your maximum remains, and whether it renews on January 1 or another date.
Who must do the assessment
Plans typically spell out which provider types are eligible. Our ADHD assessments are done by psychologists and psychological associates, both of whom are regulated members of the College of Psychologists and Behaviour Analysts of Ontario.
The example Canada Life booklets name psychologists but don't mention psychological associates. If your assessment will be done by a psychological associate, ask Canada Life whether that title is eligible under your plan. Our admin team can tell you who would do your assessment, so you can check before you book.
Questions to ask Canada Life before you book
Before you commit, call the number on your benefits card or log in to your plan, and ask:
Does my plan cover services by a psychologist? What about a psychological associate?
Are psychological assessments or testing covered under the same benefit as therapy?
What is my maximum, is it shared with other providers and how much is left this year?
Is there a per-visit limit, a deductible or a percentage I pay?
Do I need a referral or any other paperwork for the claim?
Can I get written confirmation of what's covered before I start?
Write down the date, the name of the person you spoke with and what they said. That way, you'll have a record if questions come up later.
What to have ready before you call
A call goes faster when you have the details on hand. Before you contact Canada Life, gather:
Your benefits card, with your plan and member numbers
The name of the person being assessed, and whether they're you or a dependent
The type of service you're asking about, such as a psychological assessment for ADHD
The title of the professional who would do it, such as psychologist or psychological associate
A pen and paper, or a notes app, to record what you're told
If you're not sure what title to give, our admin team can tell you before you call.
Common surprises to watch for
Even with coverage, a few details can catch people off guard. Your maximum may reset on a date other than January 1. Your plan may ask for a referral or a specific kind of receipt. Some plans pay a percentage rather than the full amount, and the amount left may already be partly used by other family members.
None of these mean you can't get help. They're just easier to plan for when you know about them ahead of time.
Assessments for children and teens
If you're seeking an assessment for your child, the same questions apply to dependent coverage. Check whether your child is listed as a dependent on your plan and whether their services draw from the same family maximum or a separate one.
Our psychologists offer ADHD assessments for children aged 6 and up, teens and adults, in Kitchener-Waterloo, Cambridge and Ottawa. If both parents have benefits, ask whether your plans can be coordinated, so one plan may pick up some of what the other doesn't.
Federal public servants and PSHCP
If you're a federal public servant, your coverage may come through the Public Service Health Care Plan (PSHCP). According to the Government of Canada, Canada Life has administered the PSHCP since July 1, 2023.
PSHCP has its own rules, so check your PSHCP plan details or contact Canada Life about what's included for psychological services before you book.
How claims usually work
Once your assessment is complete, you'll usually need detailed receipts to submit a claim. Receipts typically show the provider's name and credentials, the date of service and the amount paid. One example Canada Life booklet notes that claims can be submitted online.
Ask our admin team how billing works for your assessment, and whether direct billing is available for your plan. If direct billing isn't available, you can submit your receipts to Canada Life yourself. Keep copies of everything until your claim is paid.
If your plan doesn't cover it all
If your plan covers only part of an assessment, or your maximum is already used up, you still have options to consider. A Health Spending Account, if you have one, may help with the remaining cost. We accept Health Spending Accounts.
It's also worth asking our admin team which parts of the process are involved in your situation, so you can plan ahead. Your Canada Life ADHD assessment coverage may be clearer once you know exactly what the assessment includes.
What an ADHD assessment involves
Knowing the steps can help you ask Canada Life the right questions. Our adult ADHD assessments usually include an intake, an in-depth interview, questionnaires and any testing that's needed, followed by a written report and a feedback session to go over the results and recommendations.
The report can be useful for understanding yourself, planning next steps at school or work and deciding what kind of support might help.
Your next step
Book a free 15-minute consultation with our admin team. They can answer your questions, explain who would do your assessment and help you understand what to ask your plan. You can also read more about Canada Life ADHD assessment coverage and how insurance works with us.
If you're in crisis: if you're thinking about suicide or self-harm, or anyone is in danger, call or text 9-8-8 any time, day or night, or call 911. You can find more options on our crisis lines page.
A few questions before you book can save you surprises later. Once you know what your plan covers, you can focus on getting the answers you came for.