Does Desjardins Insurance cover ADHD assessments?
Quick answer
Desjardins Insurance does not publish one standard ADHD-assessment benefit. Whether an assessment is reimbursed depends on your specific group or personal plan booklet, which lists the provider types and the paramedical or mental-health category it pays under. Confirm the details with Desjardins before booking, and keep your receipt in case the fee later qualifies as a medical expense on your tax return.
Desjardins has no single, named benefit for ADHD assessments
Desjardins Insurance sells many different group and personal health plans, and none of them lists "ADHD assessment" as its own line item. An assessment by a psychologist, social worker or other regulated provider is usually paid, if it is paid at all, under a broader paramedical or mental-health services category, alongside other assessments and therapy visits. Two people with different Desjardins plans, even at the same employer, can get different answers to this question, so the plan document is the only reliable source. The ADHD assessment fee charged by a private clinic is separate from whatever your plan reimburses.
This pattern holds across the Canadian insurance industry, not just at Desjardins. Sun Life's consumer page on mental health coverage describes personal and group plans as setting their own annual maximums and provider lists for psychology and counselling services, and a publicly posted Manulife group plan document shows a paramedical category naming psychologists, psychotherapists, marriage and family therapists and social workers, a structure that is common but not universal among Canadian insurers. Desjardins plans are built the same way, with the specific list set out in each policy.
Which provider performed the assessment changes whether it is eligible
Most extended health plans list eligible provider types by name, and nurse practitioners are not always on that list even though they are regulated clinicians who can assess and diagnose ADHD. If a plan's paramedical category names psychologists and social workers but does not mention nurse practitioners, a nurse practitioner-led assessment may be declined even though a similar assessment by a psychologist would be paid under the same plan. For more on how this plays out with private insurers generally, see Does private insurance cover a nurse practitioner ADHD assessment?
- Psychologist: commonly listed, often with the highest annual maximum among mental health providers.
- Social worker or psychotherapist: increasingly listed as regulation of these titles has expanded in recent years, usually with a lower limit.
- Nurse practitioner: listed as an eligible provider on some plans, absent from others; ask specifically before booking.
- Psychiatrist: normally billed to the provincial health plan rather than to Desjardins, since psychiatrists are physicians.
A workplace plan and a personal Desjardins policy are not interchangeable
A Desjardins group plan bought through an employer and an individual Desjardins policy bought directly are separate products, each with its own list of eligible providers, annual maximums and rules about whether a physician referral is required first. An employee should not assume their workplace health plan behaves like a personal policy, and a self-employed person with an individual Desjardins health plan should not assume it mirrors a typical group plan.
Business owners who set up their own Desjardins group plan face a related wrinkle: as the plan sponsor, they choose which paramedical categories and maximums to include, so two small businesses using Desjardins can offer very different ADHD-assessment coverage to their staff. If you sponsor a plan and want mental-health assessments included, that is a design choice you can raise with your Desjardins group advisor at renewal, rather than something built into every Desjardins group product by default.
| Question | Where to look |
|---|---|
| Is the provider type eligible? | Paramedical or mental health services section |
| Is there an annual maximum? | Same section, usually a dollar figure per person per benefit year |
| Is a referral required first? | General conditions or exclusions section |
| Is pre-authorization needed? | Claims section, or by calling Desjardins member services |
An unreimbursed fee may still qualify for the medical expense tax credit
If Desjardins does not pay for the assessment, the fee is not automatically wasted. The Canada Revenue Agency publishes a table of practitioner types it recognizes as authorized medical practitioners for the medical expense tax credit, and that table lists registered nurses, a category that includes nurse practitioners, and psychologists as authorized in every province and territory. That is a federal tax rule, separate from any Desjardins insurance decision, and it can apply whether or not your plan reimburses the fee.
Confirming coverage before you book avoids a denied claim
The only reliable way to know how your Desjardins plan treats a specific ADHD assessment is to ask before you pay. Have the clinician's name, designation and the appointment date ready when you call, since some plans require pre-authorization for services above a set cost. A general overview of how insurance and ADHD assessments interact in Canada is covered in Does insurance cover an ADHD assessment in Canada?
- Find your plan booklet or sign in to your Desjardins member portal and read the paramedical or mental health section.
- Confirm the provider type performing the assessment appears on the eligible list.
- Ask whether a physician referral or pre-authorization is required before the appointment.
- Ask what the annual maximum is and how much of it you have already used this benefit year.
- Keep the original receipt with the clinician's credentials for your claim.
Common questions
Related questions, answered
Yes. A group plan bought through an employer and an individual Desjardins policy are separate products with their own eligible provider lists, annual maximums and referral rules. Check the booklet that matches the policy you actually have, since the terms are not interchangeable even though both are administered by Desjardins.
It depends on whether nurse practitioners appear on your plan's list of eligible paramedical providers. Some plans treat nurse practitioners like general practitioners for this purpose, others list only psychologists and social workers for mental health assessments, so confirm the specific provider type with Desjardins before booking.
Some plans require a physician's referral for paramedical or mental health services above a certain cost, and Desjardins can tell you whether yours does when you call ahead. Booking before confirming this can mean paying out of pocket even though the service itself was eligible under the plan.
Generally only the portion you paid yourself, after any Desjardins reimbursement, counts toward the federal medical expense tax credit. Keep both the clinician's receipt and your Desjardins claim statement so you can calculate the unreimbursed amount at tax time, since only that remaining portion is eligible.
Helpful next steps
References
- 1.Canada Revenue Agency, Authorized medical practitioners for the purposes of the medical expense tax credit View source ↗
- 2.Manulife, CPA Select Health and Dental Plans, plan details (paramedical benefit category) View source ↗
- 3.Sun Life, Mental health coverage View source ↗
- 4.Canada Revenue Agency, Income Tax Folio S1-F1-C1, Medical Expense Tax Credit View source ↗
This article is for educational purposes only and is not medical advice, diagnosis, or treatment. Always consult a licensed healthcare professional about your individual situation. If you are in crisis or thinking about self-harm, call or text 9-8-8, Canada’s Suicide Crisis Helpline, at any time.
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