Coverage & Cost

Private Insurance &
Extended Health Benefits

  • Coverage varies by carrier & plan
  • We provide documentation for claims

For conditions outside the OHIP-covered list, some private extended health benefit plans will reimburse hyperbaric oxygen therapy in whole or in part. Coverage varies significantly by carrier, by employer plan, and by indication. We strongly recommend confirming benefits with your insurer in writing before treatment begins.

The Process

How Coverage Typically Works

1

The patient pays Evolve directly for treatment at the time of service.

2

Evolve provides an itemized receipt with the appropriate procedure code and a brief clinical letter from the treating physician.

3

The patient submits the receipt to their insurer for reimbursement.

4

Reimbursement timelines and percentages depend entirely on the patient’s plan.

Before You Start

Questions to Ask Your Insurer

  • Does my plan cover hyperbaric oxygen therapy (HBOT) for my specific condition?
  • Is a pre-authorization or letter of medical necessity required?
  • What is the per-session reimbursement amount and the annual maximum?
  • Are there limits on the number of sessions covered per year?
  • Is there a specific procedure code or service category my plan uses?
  • Does coverage require referral from a family physician or specialist?

Claim Support

What Evolve Provides
to Support Your Claim

  • Itemized receipt for each session with date, location, and treatment parameters
  • Letter of medical necessity from your treating Evolve physician (where appropriate)
  • Summary of clinical rationale referencing UHMS indications or published evidence
  • Copy of the consultation report for your insurer’s file
What we cannot guarantee

Insurers make their own coverage decisions. Evolve cannot guarantee that any particular plan will reimburse for HBOT, even for indications with strong supporting evidence. We provide the clinical documentation; the reimbursement decision rests with your insurer.

What to Expect

Common Insurance
Coverage Patterns

Based on our experience, the following patterns are common in Ontario extended health plans:

OHIP-covered indications: not typically claimed against private insurance because public funding applies

Post-radiation injury beyond OHIP scope: variable coverage; often requires letter of medical necessity

Non-healing wounds outside OHIP eligibility window: variable; some plans reimburse with physician letter

Post-concussive symptoms / mild traumatic brain injury: rarely covered; most plans treat as experimental

Long COVID / post-acute COVID syndrome: rarely covered; evidence base is still emerging

Sports recovery, anti-aging, wellness: not covered; classified as elective

Before you start treatment

If insurance coverage matters to your decision to proceed, please request your benefits confirmation in writing from your insurer before booking. We will not begin private-pay treatment unless you have clear expectations about cost.

References

  1. Canadian Life and Health Insurance Association. Group Benefits and Extended Health Care Benefits Overview. CLHIA Industry Resources.
  2. Moon RE (ed.). Hyperbaric Oxygen Therapy Indications. 14th ed. North Palm Beach, FL: Best Publishing Company; 2019.
Medical review

Dr. Vik Agarwal MD CCFP FRCPC CAQ-HP — President, Evolve Medical Group

Dr. Seema Agarwal MD CCFP CAQ-HP — Chief Medical Officer, Evolve Hyperbarics

Last reviewed: May 2026 · Next: May 2027

Get Started

Have Questions About Insurance?

Call 1-888-851-4268 and we’ll explain what documentation we provide to support your claim.
Remember to confirm benefits with your insurer in writing before treatment begins.

Check EligibilityCall 1-888-851-4268