If you have Desjardins health benefits through work, you may be wondering whether psychotherapy or counselling is covered before you book. That is a smart question to ask early. The honest answer is that it depends on your plan, the type of practitioner you see and the wording in your own booklet. This guide walks you through how to check, without promising anything about what your plan will pay. It also explains when we can direct bill Desjardins for you.
We are a counselling clinic, not Desjardins, and we cannot see your plan or guarantee coverage. This article is general information only. Always confirm with your booklet, your member portal or Desjardins itself before you assume a claim will be paid.
The short answer: it depends on your plan
Desjardins does not offer one set of benefits that every member shares. Employers choose which services are included, how much is reimbursed and what the yearly limits are. That is why a coworker at another company can get a very different answer from yours.
Three things usually decide whether a therapy session is covered:
The type of practitioner you see
The service itself, such as individual therapy, couples counselling or an assessment
The wording and limits in your own plan
CAMH points out that some extended health plans only cover services up to a certain amount, and only for certain types of therapists. A few minutes of checking now can save a surprise later.
What Desjardins says about mental health practitioners
Desjardins publishes some general information about its group plans. Its Mental Health Focus page says members covered by its extended healthcare benefit can seek care from different types of mental health professionals, including psychologists, social workers and psychotherapists. The same page notes that the supports available depend on what each plan chooses to cover. So it is helpful background, not a promise about your plan.
One example of how plans are built
Desjardins also publishes a benefits summary for one of its group plan designs. In that example, psychologists, psychotherapists, social workers and several counsellor titles sit together in one "psychologist category" with a shared maximum. The document notes that an employer can set different maximums and reimbursement levels, and can even leave the whole category of health professionals out of the plan.
That is just one example, not your coverage. It does show why two Desjardins members can have very different answers. Your employer may have chosen a small maximum, a large one, or none at all.
How to check your own Desjardins coverage
Your own plan materials are the best source. Here is a simple order to follow:
Read the benefits booklet or coverage summary your employer gave you.
Sign in to your Desjardins member site or app and look for the health professionals or paramedical section.
Ask your HR or benefits administrator which mental health titles are listed.
Call Desjardins with your group number and certificate number ready.
Questions worth asking
Which practitioner titles are covered for mental health?
Is there a separate maximum for psychotherapy, or one shared amount for several titles?
What is the yearly maximum, and how much have I already used?
What percentage of each session is reimbursed?
Do I need a medical referral for this service?
What is the deadline for sending in a claim?
NIMH's guide to psychotherapies also suggests asking a therapist about fees and insurance before you start. Write down the answers, the date and the name of the person you spoke with.
Psychologist, psychotherapist or social worker, why the title on your receipt matters
Titles matter for claims. The Ontario government's page on regulated health professions explains what each regulated title can do. Registered psychotherapists assess and treat through psychotherapy. Psychologists can also communicate a diagnosis.
At our clinic, psychologists diagnose. Nurse Practitioners can assess, diagnose and prescribe. Registered Psychotherapists and Registered Social Workers provide therapy. Before you book, ask us which title your therapist holds. Then check whether that exact title appears on your plan. The title also decides whether we can direct bill Desjardins for your sessions.
The word "counsellor" is used in many different ways. Do not assume a title is covered just because it sounds similar. Match the regulated title on your receipt to the wording in your booklet.
Direct billing or pay first and claim
There are two common ways to use your benefits. With pay and claim, you pay the clinic and send your receipt to your insurer. With direct billing, the clinic sends the claim to your insurer and you pay only the part that is not covered.
We direct bill Desjardins through TELUS eClaims for sessions with a Registered Social Worker (RSW), a Registered Psychotherapist (RP) or a psychologist. Sessions with a Registered Psychotherapist (Qualifying), also called an RP(Q), cannot be direct billed to Desjardins, and neither can sessions with student therapists. For those sessions, you pay us and then send your receipt to Desjardins yourself.
Direct billing only changes how the claim is sent. How much Desjardins pays still depends on your own plan, so we cannot promise coverage for any member. Check your booklet, or ask us during your free 15-minute consultation. Our direct billing page explains how direct billing works in general.
What a Desjardins claim usually needs
Desjardins' healthcare claims guide lists what it wants with a claim. That includes an original receipt showing the patient's name, the date and the amount, plus the professional's name, qualifications, professional association and registration number. The guide also says a medical referral is needed when your plan requires one.
Desjardins' group claims page explains that you can submit healthcare claims online. Keep copies of every receipt and claim confirmation. If a claim is denied, read the reason carefully. Often the fix is a missing registration number or a title that is not on the plan.
If you are covered by two plans
Some people have benefits through their own job and also through a spouse's plan. Desjardins' claims page says that when your health expenses are covered by more than one group plan, you may be able to claim up to the full amount by sending separate claims to each plan. Ask both insurers which plan should be billed first, and keep the statement from the first plan to send with the second claim.
Common mix-ups that lead to denied claims
A few small details trip people up again and again. Knowing them ahead of time can save you a phone call later.
Plan year versus calendar year. Your maximum may reset in January, or on another date your employer chose.
Shared maximums. If several titles share one amount, a session with any of them uses up the same pot.
Couples and family sessions. Ask how these are claimed, since plans can treat them differently from individual sessions.
Late claims. Most plans have a deadline for sending in receipts, so do not let them pile up.
When in doubt, call Desjardins with your booklet open and ask them to read you the exact wording. It is their job to explain your plan, and it is fine to ask more than once.
If your plan is limited
Sometimes the answer is no, or the yearly amount runs out partway through. That does not have to mean the end of support. You could space sessions further apart, use a Health Spending Account if you have one, or see a student therapist to lower the cost. We accept Health Spending Accounts. Our insurance hub explains more about how Ontario benefits usually work.
If you also have benefits through another insurer, our post on Equitable Life coverage walks through a similar check for that company.
None of these options means therapy will be free. They are practical paths when coverage is thin or already used up.
What therapy costs at our clinic
Individual sessions with a therapist are $130 to $200. Couples or family sessions are $170 to $200. Student therapists offer sessions for $0 to $80. There is a one-time $50 setup fee for new clients, which is not charged for the free consultation. Psychologist fees depend on the service and can be discussed during your free consultation.
Your next step
You do not need to have every benefits answer before you reach out. A free 15-minute consultation lets you ask about our team and fees, whether your sessions can be direct billed to Desjardins, and which therapist titles might suit your plan. We see clients in Waterloo, Kitchener, Cambridge and Ottawa, and online across Ontario. No referral is needed to start with us.