7 Tips to Better Understanding your Health Insurance

What is your Health Insurance trying to tell you?

Copays, deductibles, co-insurances, and monthly premiums. How does one comprehend what they are actually going to spend when they come in for a physical therapy visit? While the answer may not be as cut and dry as you would prefer, it is still obtainable. Here are some questions you can ask your insurance company:

    1. Is there a visit limit on your coverage? Some companies will put a visit limit on physical therapy visits based on the calendar year. Some insurances will only cover services for “consecutive days”. For example, if your insurance provider says they will cover a case for your knee for 60 consecutive days, and you began therapy on the first of March, your coverage would expire on April 30th.
    2. Is the insurance coverage based on a benefit year or calendar year? Knowing the answer to this question will ensure that you know when your coverage is terminated or when your deductible will reset.
    3. The big one. How much is your copay? While this seems obvious, it is always good to double-check. Some companies tailor their policies to have their copay change in the middle of a patient’s care. For example, some plans will charge a $10 copay for visits 1-20, but visits 20-40 will be $20.
    4. Does your insurance policy carry an Out of Pocket Maximum? Your insurance may carry a $2,000 deductible and a $40 dollar copay. But your Out of Pocket Maximum may only be $4,000. This means if your total out of pocket expense hits that $4,000 mark, your services are covered at 100% for the remainder of your benefit year.
    5. Always check with your employer’s benefit coordinator about possible upcoming changes to your health plan.
    6. By law, when services are rendered through your health insurance, the company will supply you with an EOB (Explanation of Benefits) that will explain that the medical professional charged, what the insurance is going to cover, and what you will ultimately be responsible for.
    7. Ask questions! If you do not understand something about your plan, statement, or explanation of benefits do not hesitate to ask!

At Strive, your plan will always be verified prior to your first visit. Our billing specialists will reach out to your insurance company to confirm that your coverage is active, furthermore to see what your out of pocket responsibility looks like.

For more information, click here: https://www.strivephysicaltherapy.com/patcenter/


Drew Kelly, Inbound Marketing Strategist

Drew Kelly

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