Physical Therapy

Health insurance often covers many expenses of health, from blood work to preventive care, and portions of your hospital bills, etc. But what do most insurance policies cover when it comes to physical therapy?

The answer to that question really depends on the policy, however, the majority of policies say that health insurance coverage for physical therapy treatments requires the order (prescription) of a physician, nurse practitioner, or physician assistant.

Policy holders may refer themselves to physical therapy, but these services are often not covered or may not be reimbursed unless prescribed by a clinician.

What exactly is physical therapy? Physical therapy is basically working with a therapist to regain optimal physical movements and capabilities. For example, a patient who undergoes hip replacement surgery, would follow that up with physical therapy to teach the body how to use the new hip properly. A patient who has surgery on their knees or ankles, may need physical therapy to work the knees and ankles back into use after having them casted and out of use for a time. Physical therapy is a gradual process of helping the body to recover from injury, and regain previous or even better scope of movement, etc.

For certain procedures, physical therapy is preventive, rather than restorative. For example, rather than immediately having knee surgery, a clinician might first try physical therapy to see if surgery can be avoided through working with the knee. Often times motion can be restored with gradual work, and the help of a professional therapist. On the other hand, physical therapy may be an aftermath, or rehabilitation technique as well, meaning after knee surgery, one goes to physical therapy to work the knee back into healthy movements without damaging it. This is done to help acclimate the knee, elbow, wrist, hip, or whatever it may be, back into normal activities, and the scope of movement desired.

Because some wish to do more physical therapy than is prescribed, as it can be very rewarding and helpful, health insurance generally specifies how much will be covered, and whether or not you choose to continue physical therapy beyond that point is entirely up to you, but you would be financially responsible for it.

Under some health insurance policies physical therapy is covered much like a routine doctor's visit, where you would have a co-payment and nothing more. However, this is somewhat rare.

If you are a stroke survivor, and physical therapy is required, or recommended by your physician, then generally insurance would cover it as part of stroke treatment. Many victims of stroke find that physical therapy is a great way to regain their normal activities and abilities. Physical therapy can be life changing for many.

When it comes right down to it, it is impossible to say whether or not physical therapy is going to be covered by your health insurance, and if so how much. In most cases that is determined first by what your primary care physician prescribes, and secondly by the cause for the need of physical therapy.

If self-prescribed, physical therapy is generally never covered. So if you feel you need or want physical therapy and your physician does not prescribe it, talk to your physical therapist about price breaks, discounts, and other ways to handle the expenses associated with it.

When purchasing health insurance be sure to understand under what circumstances, how much, and what portion of physical therapy is covered. You do not want to go and get a bunch of physical therapy done only to afterward find that it is not covered by your insurance, and that the expense of rehabilitation is going to come out of your pocket.