Employees with diabetes aren’t accessing dietitians and other supports available through their plans

November 17, 2023

For plan members, sponsors and administrators

Manulife claims analysis indicates that plan members with diabetes aren’t making full use of the different Extended Health Care (EHC) services available through their plans. As we note below, this might affect their ability to best manage their diabetes.

For example, Manulife looked at the number of plan members who have submitted claims for diabetes medication. Only an exceedingly small percentage (<1%) of these claimants were found to be using the services of a dietitian in combination with medication.¹

Heidi Riggs, Health and Dental Product Manager at Manulife, is concerned by the findings. “This low use of coverage for dietitians is surprising,” Riggs says. “Especially when you consider the important role that diet and weight loss can play in the management of diabetes and pre-diabetes.”

Diabetes Canada recommends people with diabetes should seek out nutritional counselling to help determine their best diet.² So, periodic reminders to your employees about the full range of health benefits available through your plan could produce better health outcomes for those managing diabetes.

• Dietitian. The food we eat influences the glucose (sugar) levels in our blood. So, it’s important for people with diabetes to learn about meal planning, portion control, snacking, and how to achieve a balanced diet when managing the condition. A dietitian can help people create a personalized meal plan that fits their needs and lifestyle, and they can provide nutritional counselling to help people understand how different foods affect their blood glucose levels.³ For some people, weight loss/weight management is another area where dietitians can offer guidance and education to help people set and reach their goals.²
• Foot care. Prolonged levels of high blood sugar associated with diabetes can cause nerve damage in the hands and feet (peripheral neuropathy), so a comprehensive diabetic foot exam can help avoid complications.⁴ Doctors, paramedical providers, and registered nurses can provide complete foot exams for patients with diabetes. Riggs says, “Coverage for foot care services can help people avoid serious complications by educating them on how to look after their feet and manage any issues that might arise. Under a Manulife extended health care plan, registered nurses and registered practical nurses can provide in-home foot care to people diagnosed with diabetes through the private-duty nursing benefit.”
• Naturopathy. A naturopath can offer dietary guidance to an individual with diabetes. The services of a naturopath are eligible expenses under many group benefits plans. Supplements recommended by a naturopath are not covered, but they are eligible for consideration under a Health Care Spending Account or a Lifestyle Spending Account.
• Health Care Spending Accounts (HCSA). HCSAs can be used to offset costs when the coverage under the EHC plan has been reached, or for eligible expenses that fall outside the plan. Read more about HCSAs.
• Lifestyle Spending Accounts (LSA). LSAs can be used to pay for expenses such as gym and fitness memberships and equipment, nutritional counselling, cookbooks and cooking classes – all of which can be beneficial to diabetes management.
• Medical equipment. Coverage for medical equipment and supplies used by people with diabetes, including Insulin Pumps and Continuous Glucose Monitors, is determined by the provincial health plan and, in some cases, the patient’s age.

This chart (below) can be used as a guide to help your members navigate the claims process. 

Coverage for insulin pumps

Coverage for Continuous Glucose Monitors

Note: For complete details, check with your provincial health plan - certain criteria must be met in order to qualify for funding by the public plan.

^{This article is for educational purposes only and not intended to replace the advice of a medical doctor. Please contact your health care provider or physician for advice.}

^{Every group benefits plan and provincial health plan is different. To confirm which services you are eligible for, you should refer to your benefits booklet, or speak to your plan administrator (the person in your organization responsible for your group benefits plan).}

Sources:

_{1 Manulife Claims analysis, 2023}

_{2 Diabetes Canada, https://www.diabetes.ca/health-care-providers/clinical-practice-guidelines/chapter-11#panel-tab_FullText, 2023}

_{3 https://health.clevelandclinic.org/diabetic-diet/, 2021}

_{4 Diabetes-Related Foot Conditions: Symptoms, Causes, Treatment & Prevention (clevelandclinic.org), 2021}