Below is a recent email we received from a client needing physical therapy and our reply. Please send us in your questions via email, Facebook or through our Website. We want to answer Your questions!
“Dear Jeremy, My PCP wants me to have some therapy, will my Medicare Supplement Insurance cover it and, how do we find out how many treatments it \ will pay for ( 1, 2 ,3 ,4..)?
Thank you in advance my good man as always for answering my questions and lowering my stress. – Chuck"
Dear Chuck,
Your question is actually addressed and answered by Medicare - which is your primary insurance. The insurance is secondary and follows all the rules and regulations set by Medicare. The Doctor, Service Provider and Medicare may be able to answer how many initial visits are covered. Also, at any time, you may call your insurance company to ask any questions. The answer is: there are limits and caps on monetary values related to therapy coverage. Your Dr. may expand those caps as long as the ongoing therapy is medically reasonable and necessary services.
On the Medicare website, https://www.medicare.gov/coverage/speech-language-pathology-services you can find the complete explanation (also printed out in full below). At the end of the answer it states:
Your costs in Original Medicare: You pay 20% of the Medicare-approved amount, and the Part B deductible applies.
Your Medicare Supplement plan pays this 20% and your Part B deductible. I hope this answers this question for you.
Thank you for allowing me to help,
Jeremy