Understanding Your Physical Therapy Insurance Benefits

Health insurance plans can be difficult to navigate, but we’ve got your back! Health insurance premiums have been on the rise, so it’s important to understand what you’re paying for. Most health insurance plans cover physical therapy visits, anywhere from 10 to unlimited visits per year. It’s important to know how many you get per year so you can take advantage of what you’re paying for. These visits don’t roll over to the next year, so be sure to utilize them! Here’s a list of questions that we ask your insurance provider when discussing coverage and benefits. If you would like to inquire about coverage on your own, here’s what to ask your insurance company about your physical therapy benefits:

  • What is my deductible and how much has been met so far?
  • How many physical therapy visits am I allowed each year?
  • How many visits do I have left?
  • Is Pacific Neuro Therapy an in-network provider under my plan?
  • Is a doctor’s referral or prescription for physical therapy required under my plan?
  • Does my plan require authorization prior to receiving treatment?
  • Is a copay required?
  • Do I have coinsurance?
  • What is my out of pocket maximum and how much is remaining? Once this has been met, your provider will cover 100% of the bill!
  • Does my coverage run on a calendar year or plan year?

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