Typically an insurance plan will have a deductible, coinsurance or copayment, and an out-of-pocket maximum. Although every insurance plan is different and may not have each of these, it’s important to understand them and how they work. So, will you have to pay for physical therapy? Let’s discuss it!
Coverage
Your plan’s deductible may not apply to every health care service that you need. You might not have to pay your deductible for things like physical therapy or office visits. In these cases, the insurance company will pay some or all of the bill entirely.
Coinsurance amounts can be different depending on the type of service. For instance, there may be a 10% coinsurance for wellness visits and a 20% coinsurance for exam visits. While some services may not require a coinsurance at all.
Most insurance plans have some sort of copay for one or more services. Each service has a different copay. For example, you may have a $30 copay for specialist visits, but a $50 copay for lab tests. On the other hand, some services may not require a copay at all.
Depending on your plan, your insurance may cover physical therapy completely, at no cost to you. As a courtesy, our billing department verifies your health insurance benefits prior to your first visit. It is important to understand that you are under contract with your insurance company. Your Insurance company determines the amount owed to Borja PT. This is never determined by Borja PT.
Please do not ask the billing department to adjust any charges. The insurance company determines these payments and we are not permitted to adjust them. It is very important for you to know your benefits so unexpected balances do not occur. The billing department files with many insurance companies that have several different types of plans. Therefore, you must make sure your benefits are accurate.
For more information about health insurance, click here.
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