Will my insurance cover in-home physical therapy?
Navigating the intricacies of insurance coverage can be daunting, and we’re here to help you with that process. At Active Health Solutions, we believe in full price transparency and will never surprise bill our patients.
- Consider the benefits of an out-of-network provider: As an out-of-network provider, we are enabled to see our patients for a full, hour-long one-on-one session without the strict demands of an insurance company. This allows our expert physical therapists to treat our patients as they have been trained, not according to an in-network contract. We have seen that patients typically require fewer and less frequent visits when treated by our in-home expert therapists.
- Review your insurance policy: Start by examining your insurance policy documents regarding out-of-network benefits, which should detail the scope of your coverage. Typically you will have an out-of-network deductible which is the amount that needs to be met before your coinsurance kicks in. At that time, your insurance company covers a certain percentage (your coinsurance) of the allowed amount per each service code. With plan questions, contact your insurance company’s customer service hotline or online portal for further clarification and to confirm your benefits.
- Obtain a physician referral (rarely required): While uncommon, some insurance plans may necessitate a referral or prescription from your primary care physician to cover physical therapy services. Check with your insurance provider and obtain the necessary documentation if needed.
- Submit superbill for reimbursement: After each session, we will provide you with a superbill which is a medical receipt that includes the necessary codes and license numbers for insurance reimbursement. Almost all commercial carriers have online portals for submission. Once reviewed, your insurance company will send you a check for direct reimbursement. We never receive reimbursement from your insurance company so all of the payment goes to you.
- Medicare consideration: At this time, we have no relationship with Medicare and therefore are unable to provide superbills to patients for reimbursement. We are happy to help you find someone who accepts Medicare to ensure you receive high quality care.
By taking these proactive steps, you can confidently and clearly understand any associated costs. Consider the following to help offset the costs of your therapy:
Utilize Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs): If you have an HSA or FSA, you can use these funds to cover the costs of your at-home physical therapy visits.
Even if your insurance doesn’t cover the full cost, you can still request an appointment to learn about your options.