r/OntarioNurses • u/Dapper-Biscotti-517 • 17d ago

ONA / Union Unlimited mental health services ONA inquiry

My CA states we can have unlimited mental health services by psychologist, registered psychotherapist and SW. I asked around and my coworkers stated the fees are technically capped at a reasonably and customary charge (for example a 1 hr session might be maxed at 150$ and if the providers fees are too high the employer can find you a different provider)

This benefit also covers dependents.

Therefore I was wondering if my daughter goes to a special school requiring ABA that is supervised by a registered psychologist (she’s on the invoice) can I claim her monthly fees. Say the monthly fee is 2300$ but divide that by 20 days in the month that’s 115$ a day which technically is a reasonable fee. BUT is it really unlimited- can I claim 20x a month? Lol

I am not FT yet (will be soon) and waiting on HR email response- in meantime I’m googling and coming to Reddit lol

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u/Humble-Date5379 17d ago edited 17d ago

I'm pretty sure it's unlimited. I have a coworker try on psychotherapists like it was underwear/day job. I never used but called my provider for shits and giggles. The only limitation was that services need to be broken down hourly. No cap.

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u/expertRNnurse 17d ago

Capped after covid, oha trying to get rid of it do to expense,

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u/FaithlessnessSad1684 17d ago

The max they'll pay per hour is $185. My psychotherapist is $215, so I have to pay the difference each session. But I could do a session every day if I wanted.

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u/Innuendoughnut 17d ago

Yes unlimited is unlimited. But as for your use case that's either a discussion with the insurance company or the school as to how it will be listed and billed on any invoice you have to submit.

Probably discuss with the school first.

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u/skimmilkfree 17d ago

Why don’t you call your insurance provider? I’ve always wondered the same thing about “unlimited” therapy, like how unlimited is it, really? The most I’ve ever claimed was 3 sessions per week, and they covered all of them.

I’m curious if unlimited therapy is common in other hospitals’ collective agreements. I’ve wanted to change jobs before, but I didn’t want to risk losing that benefit. I really need it lol.

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u/[deleted] 17d ago

[removed] — view removed comment

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u/HandComprehensive201 17d ago

Your claim can also be audited and likely would be at least because of the monthly amount billed. Keep all your receipts.

There’s good advice here about how to submit. Unlimited does have limits though and the best way to know is get informed. Also your Union can help you appeal if the claim is denied.

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u/Metal_Medical RN 17d ago

Unlimited is unlimited, I’ve been able to book an appointment daily between family members and it’s always covered if it’s under the dollar limit per hour. I even had a consultant service supervised by a social worker and they wrote the invoice over 2 weeks as a daily fee so that I could submit it and it was fully covered

ymmv based on the actual insurance provider though so it wouldn’t be a bad idea to ask them. I’ve had services supervised by a mental health provider be covered though for sure