Posts Tagged ‘tim newton’

Salvere Blog: Physical Therapy and “Do They Take My Insurance?”

March 4, 2019
knee-painEver found yourself needing help with some sort of annoying chronic pain or injury and someone suggests a physical therapist? Is your first question, “But do they accept my insurance?” Completely understand that this question matters to many of us as we need to be able to afford these services. Often, it does not tell the whole story of “cost”.
First and foremost, for most insurance, you need to reach your deductible first so, if you did not get there yet, it will all come directly out of your pocket anyway. All insurance companies come with their own set of rules so check the specifics of yours! Now, if your insurance allows out of network providers, paying for a PT directly may contribute to your deductible.
Second, copays for physical therapy range between $30-$60 per visit. Generally, copays do not count towards your deductible. If you schedule 2 appointments per week for one month, that equals $240-$480 per month for your contribution to PT IN your network. Now, some insurance companies will reimburse if you submit your expense for a therapist who does not accept insurance. Often, you receive a reimbursement that brings your total out of pocket very close to the amount you would have paid in a copay.
Finally, I’ve seen many times where a client sees a PT only because they accept their insurance only to come out not feeling that much better. On the flip side, many times a client sees someone who does not accept insurance feel better sooner so in the long run, it costs less or close to what they accumulate in copays for weeks and months. For example, take the $258 – $516 example from above. (Go 3x per week and its even more!)
Using $150 as the average cost for a PT you pay directly, you could see a therapist about 2-3x for that same amount. A therapist who does not accept insurance can spend more time with each patient and provide a more personal/longer session.
Physical Therapist Tim Newton put together a checklist for you to research and find out the specific details of your insurance plan. If you know a therapist who comes with great recommendations and does not take insurance, investigate it anyway!! It’s not always what it seems.
by Lisa Martin, owner and personal trainer at Salvere Health and Fitness. To contact, email or call 410.707.0055.
We welcome your thoughts and ideas! Thank you for reading and taking the steps to become a healthier YOU.