When breaking down the payment for your physical therapy session, you may get overwhelmed with questions.

Mettler Center understands there’s a lot to consider regarding coverage. With our PT patient’s guide to understanding insurance, you can shift your focus from coverage to recovery.

1. Insurance Jargon

Some basic terms will come up with regularity when you’re reviewing insurance coverage. We’ve included them in our PT patient’s guide to understanding insurance, as they’re helpful in providing a fundamental clarity when you’re reviewing your plan.

Deductible: A deductible is the out-of-pocket amount you have to pay before your insurance starts to cover the costs. Even when your insurance starts to pay, it can still bill you for copays or coinsurance each visit.

Copay: A copay is the fixed amount you’ll typically pay at the time of service. The amount depends on the insurance plan you have as well as on what type of service you received. Many plans allow the copayments to go toward the deductible.

Coinsurance: This is essentially your fraction of the total cost. It’s when the out-of-pocket amount paid at the time of service is calculated as a percentage of the total allowed amount for a service, and it can vary per service or visit.

2. Do I Need Insurance for PT?

If you don’t have insurance that pays for physical therapy, you can pay out-of-pocket for the entire cost of the service directly to the provider. At Mettler Center, we can help you find an affordable option that works for you and your budget while giving you the quality of care you need. We are always happy to check your insurance to see what would be the best option for you.

3. Does Insurance Cover PT Services?

Most types of insurance will pay for physical therapy if it is deemed medically necessary. Insurance companies often require a physical therapist to provide the service.

Getting a free pain consultation is a productive first step in determining which type of services you’ll need moving forward.

We can give your insurance a call for you to confirm whether or not physical therapy services will be covered and let you know what the out-of-pocket costs will be, if any.

4. What Do I Do If My PT Isn’t Under My Insurance Plan?

A lot of insurance companies allow their patrons to select services outside of their participating providers. Should you choose a PT provider that isn’t included under your insurance plan you may have to pay a higher out-of-pocket amount than you would pay with a provider under your plan. Sometimes people still prefer this, as it allows patients to seek treatment from the physical therapist of their choosing and get the best care.

If you’re looking for physical therapy in Champaign, IL, Mettler Center has got you covered. We personalize our services to provide you with an optimal and individualized course of therapy, getting you back to your best self in no time.

Peggy Hau, PT, MSc PT,  DPT  is a licensed Doctor of Physical Therapy at Mettler Center. 

Call 217-398-9800 to schedule a free 30-minute consultation with a physical therapist.