Will Your Insurer Cover Physical Therapy?

Austin, TX – Knee Pain Doctor

If you’ve never gone to a physical therapist before, you may not know what to expect. If you were injured and physical therapy is part of your rehabilitation, your current health insurance may cover your treatment. If you’re not sure what your insurance will pay for, it is important to inquire about your coverage before you start treatment. That way, you won’t be burdened by unexpected costs, nor will you be forced to alter your treatment plan in favor of your budget. 

What Does Insurance Cover?

Most insurance plans will pay for physical therapy when it is medically necessary. You can ask your physical therapist or insurance company which procedures are covered and which aren’t. Even if the physical therapist you’ve chosen doesn’t participate in your insurance plan, you may be able to receive care with some costs out of pocket. 

As an experienced Austin, TX knee pain doctor – including those who work at Austin Physical Therapy – can confirm, patients too often wait to seek treatment because they aren’t sure if it will be covered and/or how much it will cost. Knowledge is power. If you don’t know how much physical therapy will cost… ask! Then, you can make whatever informed decision is best for you at this time. 

What Physical Therapies May Be Rejected?

Some procedures may not be deemed medically necessary under your current insurance plan. These types of therapies may include sports performance enhancement, education classes, and wellness programs. If you choose physical therapy to better yourself but not help you function or recover from an injury or illness, you may not have coverage. An insurance company can help you understand which procedures are covered and which aren’t. Before you go to a doctor who doesn’t accept your insurance, make sure that your insurance allows out-of-network physicians. Medicare and most HMOs do not allow you to find doctors out of network.

What Happens if You Don’t Have Insurance?

If you don’t have any form of health insurance, figuring out how to pay for rehabilitation may be more complex. Generally, you’ll have to pay the doctor’s costs out of your pocket. If you have difficulty paying, you may want to discuss your options with the office. Some physical therapists may allow you to have a payment plan. Others may try to modify your treatment so that it doesn’t cost as much. If you’re having trouble with the cost, consult with your physical therapist immediately. They may be more likely to help you if you talk with them about your situation before you miss a payment.

If you have suffered an injury or illness that requires treatment from a physical therapist, you may not have time to worry about the cost. If you need therapy for medical reasons, then odds are you have coverage for it. Consult with a physical therapist as soon as possible to find out if they take your insurance.

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