‘Tis the season for considering resolutions for 2020. If you’re like most people, this will likely include a focus on improving health.
Whether your goal is to eat healthier, exercise more, or shed a few extra pounds, one thing is clear: living a healthier, more active life is a high priority for you.
“That’s why it’s also critical you fully understand your 2020 health insurance plan and how it works,” says Impact physical therapist Laura Perry. “Knowing if your insurance covers services such as physical therapy, for instance – and, if so, how that coverage works – can give you a leg up on reaching any goals meant to improve your life and health.”
“Physical therapy is the expert medical provider in reducing pain and optimizing movement so that you, the patient and client, can live the life you want,” said Perry, DPT, of Impact Physical Therapy of Hillsboro. “Physical therapists are one of the only medical providers that still have the luxury of time to get to know their patients and discuss their plan to help turn adversity into opportunity.”
“This translates to greater success in safely reducing pain, improving movement and optimizing quality of life,” Perry adds, “often eliminating the need for expensive surgeries and prescription meds.”
“Unfortunately, though, health insurance is not always a catch-all,” Perry said. “When you choose those lower premium, high-deductible plans, you’re taking on more risk. This means, depending on your benefits and how they pay out, high-value services like physical therapy may not always be covered right away. If your plan has a deductible, that will have to be reached before insurance starts to cover costs. Ultimately, you may be responsible for 100% of the charges until that deductible is met.”
To find out if your current and/or future health insurance policy covers physical therapy, Perry suggests the following:
Talk with Your Employer: As most people still get their insurance through an employer, speak with them about your health insurance options. This may require speaking with someone in human resources or contacting the insurance expert who administers your company’s plan. Ask about referral requirements, co-pay, deductibles and co-insurance as it relates to physical therapy services.
Ask About a Health Savings Account (HSA): If your employer offers to manage a health savings account for you and your family, strongly consider doing so. The pre-tax dollars in your HSA can be used to pay for your PT appointments, deductibles and co-pay, saving you some money in the long run.
Talk with Your Physical Therapist: When beginning your course of treatment through a physical therapist, be up front with her or him about your insurance coverage. Do you have a co-pay? Do you have a high deductible? Have you met your deductible, and how close are you to doing so? Based on your projected course of treatment, the physical therapist can help you determine the most affordable path moving forward.
Consider Cash Pay: This may seem counterintuitive when you have health insurance, but if you’re far from reaching your deductible, it may be cheaper to bypass insurance and just pay as you go. By removing insurance from the equation, PT clinics can often offer a lower rate for services, saving you money. But, there’s a catch.
“Once we’ve decided to bill a visit as cash pay or to health insurance, by law we can’t undo that decision,” Perry said. “That’s why I always stress to the patient that being proactive in communicating with the PT staff, and the office staff, is paramount.”
Perry adds that monthly payment plans can also be considered early in the process by some clinics, but this can’t happen without good, honest communication about insurance coverage and a projected course of treatment.
For more information about getting the most from your health insurance when seeing a physical therapist, all while keeping out-of-pocket costs at a minimum, contact Impact Physical Therapy of Hillsboro at 503-615-5969 or Banks at 971-713-3960.