Insurance Coverage for Physical Therapy

Whether you have recently been injured or you are experiencing chronic pain or limited mobility, going to a physical therapist can greatly improve your quality of life. For many people, concerns about how much regular sessions cost is a big roadblock to getting much needed care. Fortunately, if you have an ACA-compliant health insurance plan, rehabilitative services like physical therapy are listed among the essential health benefits. Your health insurance agent can help you understand your specific policy, so you know what to expect if you need physical therapy.

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Is Physical Therapy Covered Under Health Insurance

Do I Need a Referral to See a Physical Therapist?

Whether you need a referral to see a physical therapist depends on your health insurance plan. Generally speaking, if you have an HMO plan, you need a referral from your primary doctor to see a specialist, such as a physical therapist. If you have a PPO, you do not need a referral to see a specialist. However, it is important to note that even if your health insurance plan does not require that you get a referral to see a physical therapist, the therapist may require a referral from your doctor. Also, give your health insurance plan a call and inform them of your need for rehab and find out if you need and pre-authorizations.

Are Physical Therapy Sessions Covered by My Health Insurance?

If you have health insurance through your employer, you purchased your policy through Nevada Health Link, or if your plan was purchased “Off Exchange” (not purchased through Nevada Health Link) but is still an ACA (Obamacare) plan, then your plan is ACA-compliant and covers physical therapy for new or old injuries. Be aware that you’ll have deductibles, co-insurance, and co-pays most likely. You’ll need to ask your broker/agent or your health insurance company how your plan works. Therefore, it’s so important to have an agent you can ask these types of questions to and get quick answers.

It is also important to note that your health insurance may only covers a certain number of sessions, regardless of how many sessions you need. Your doctor may want you to attend 60 physical therapy sessions, but your health insurance may only cover 36 of those sessions. Again, ask your agent or health insurance plan.​

Quote and or Enroll

In addition to your health insurance, there may be a few other avenues for covering the cost of physical therapy, depending on your situation. If you need physical therapy to recover from an injury in a car accident that you are not liable for, then the other driver’s liability auto insurance should cover your medical bills. If you were injured at work, you may be entitled to worker’s compensation, or if you were injured while you were on active duty for the military, there may be government programs that cover physical therapy.

 

Finding Physical Therapy Coverage with Nevada Insurance Enrollment

Physical therapy can be expensive, but by knowing how much your health insurance covers and how much you must pay out of pocket, you and your doctor can come up with an affordable care plan. At Nevada Insurance Enrollment, our health insurance agents can help you understand your coverage or find a health insurance plan that meets your needs.

Stating Your Income For Health Insurance Subsidy

Stating Your Income For Health Insurance Subsidy

When you claim you make a certain amount of money in a year (and receive a subsidy), you must try to be as accurate as possible and notify them of any changes that may occur throughout the year. Be honest in stating your income. There are very serious consequences to playing games with your income.

Can You File for Medical Bankruptcy?

Can You File for Medical Bankruptcy?

The short answer is yes; medical debt is considered non-priority unsecured debt and can be discharged in bankruptcy. While you cannot target medical debt in bankruptcy, this process can help lower payments or eliminate the debt altogether.

Get The Most From Your Health Insurance Plan

Get The Most From Your Health Insurance Plan

Today’s Health Insurance plans may offer benefits above and beyond just doctors and hospitals, such as free preventive services, fitness programs, teledoc/telehealth, and so much more!

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