Insurance

Frequently Asked Questions

Does my health care plan cover physical therapy?

It is advisable that you call the 800# on the back of your insurance card to verify if you have physical therapy benefits and if so, how many visits are allowed per calendar year.

Is my deductible and my copay the same thing?

DEDUCTIBLE is the set amount of money you pay out of pocket for covered services per plan year before your insurance starts to share costs. COPAY is also a set amount of money, but it is a fixed fee attached to certain covered services.

What is out-of-pocket maximum (OOP)

Your out-of-pocket (OOP) maximum is the most you’ll pay for medical services within your policy’s calendar year. Almost all insurance carriers require services to be in-network and covered by your plan to count toward your OOP.

Is physical therapy covered by insurance? Do I need a referral for Physical Therapy?

A majority of insurance plans do cover physical therapy services. The coverage amount may vary depending on the company and your specific plan. In Michigan, you can directly access physical therapy services without a physician referral, HOWEVER, most insurance providers will only cover services when a referral has been obtained.

Insurance Plans accepted/not accepted

Insurances accepted:

AETNA/AVAILITY
ALLSTATE
AMERIPLAN
ANTHEM BCBS
ASR HEALTH COVENANT (NEED AUTHORIZATION)
ASSURANT HEALTH
BCBS (NO HIGHMARK)
COFINITY
CONNECT CARE
COURSOURCE
EMPIRE BCBS
HEALTHPLUS
HUMANA
MEDICARE (ALL EXCEPT HIGHMARK)
PRIORITY HEALTH MEDICARE ADVANTAGE
TRICARE/CHAMP VA
TRICARE EAST
UNITED HEALTHCARE
WORKERS COMP

Insurances NOT accepted:

No HMO plans

BLUE CARE ADVANTAGE-OUT OF STATE
BLUE CARE NETWORK
CIGNA GWC (GREAT WEST)
HIGHMARK BCBS
MCLAREN
MEDICAID (INCLUDING MIDLAND HEALTH PLAN, MI HEALTH, MOLINA, MERIDIAN HEALTH PLAN)
PRIORITY HEALTH
ST MARY’S HOSPITAL