As the year comes to an end, many of us are close to meeting our health insurance plan’s deductible or out-of-pocket maximum. If this is you, take advantage of the opportunity to feel better before the New Year and it might not cost you a dime!
We’re here to help you navigate potential year-end insurance savings and how it can save you money on your physical therapy sessions for the remainder of the year.
Before diving into your potential year-end insurance savings, let’s define common insurance terms:
A specific amount of money that you need to pay for medical services before an insurance company will cover the cost of your medical services. Example: If your deductible is $3150, you would need to pay $3150 out of your own pocket before your insurance company starts paying a percent of your medical services.
The percentage of cost you will pay for medical services after you’ve paid your deductible. Example: If your co-insurance is 40%, you are responsible for paying 40% of the medical service you used while your insurance company is responsible for paying 60% of the medical service you used. If your physical therapy session costs $100, you will pay $40 out of your own pocket and your insurance company will pay $60. That’s 60% in savings right there! The amount you pay here contributes to your out-of-pocket maximum.
The maximum amount of money you will need to pay for medical services (per year) before your insurance company pays 100% of the cost of your medical services. Example: If your out of pocket maximum is $6650, you would need to pay $6650 out of your own pocket before your insurance company covers all costs of medical services. If you’ve met this amount for the year, your insurance company might cover most or 100% of your physical therapy costs. As we mentioned above, the co-insurance you pay with the use of any medical service contributes towards your out of pocket maximum. Co-pays (see below) also contribute towards your out of pocket maximum.
A fixed amount of money that you pay to a medical service provider before receiving their services. Co-pays apply after your deductible has been met. Example: If your co-pay for physical therapy is $20, you will need to pay $20 for every session you attend. The amount you pay here contributes towards your out of pocket maximum.
Sounds Like You?
Now that you have a general understanding of common insurance terms and how each of them work, ask yourself the following questions:
- Have I met or am close to meeting my deductible this year?
- Have I met my out of pocket maximum this year?
- Do I want to start the New Year pain-free?
If you answered “YES” to Question 1 and/or 2 and Question 3, physical therapy might be available to you at little to no cost for the remainder of the year! If you would like us to verify your benefits for the remainder of the year, give our friendly and helpful staff a call 312-489-8579.
Wishing you and your family happiness and health this holiday season,
The REAL pt team