Hey there, fellow insurance navigators! Our trusty insurance policies do not always embrace all therapies equally when it comes to the crux of our health and well-being. Today, we’re zeroing in on a treatment that’s all too often whispered about, despite its powerhouse role in our lives: pelvic floor therapy.
As your go-to guides in the labyrinthine world of insurance coverage, we’re here to dive into the nitty-gritty of pelvic floor therapy covered by insurance. So, grab your policy paperwork, and let’s decode the fine print together!
Does insurance cover pelvic floor therapy?
The great news is that most insurance carriers usually cover pelvic floor therapy. Why, you ask? Maintaining a healthy pelvic floor can prevent many medical issues and might even save you from costly surgery.
However, just like snowflakes, every insurance plan is unique. Therefore, it is crucial to check with your insurance carrier to determine what is covered. Remember to ask about any out-of-pocket costs, too!
But here’s a heads-up: Even if your policy covers pelvic floor therapy, not all therapists might be in your plan. And some therapists work in cash-only clinics, although they might provide an invoice for insurance reimbursement.
How do you get an appointment with a pelvic physical therapist?
Do you need to book an appointment? No problem! Your primary care provider, gynecologist, or nurse practitioner can hook you up with a referral or prescription for pelvic physical therapy. They can often recommend a fabulous therapist who’s trusted and effective.
You can also directly contact a pelvic floor therapist in many states without a referral. But keep in mind that this might affect your insurance coverage.
What happens in pelvic physical therapy?
Your therapist will discuss your medical history, current symptoms, and goals at your first appointment. They’ll check out your posture and movement, focusing on your pelvis, spine, and hips. Sometimes, they might suggest an internal exam to get a clearer picture, but it’s your call.
Your therapy could include exercises like toe taps or heel slides, diaphragmatic breathing, and even Kegels—those popular exercises for strengthening your pelvic floor. There’s also electrical stimulation to ease muscle spasms and pain, and trigger point therapy for healing.
Does Blue Cross Blue Shield cover pelvic floor therapy?
BCBS plans cover pelvic floor electrical stimulation with a non-implantable stimulator for the treatment of stress, urge urinary incontinence, fecal incontinence, and pelvic organ prolapse. However, coverage may vary depending on the specific plan and location. Contact your BCBS provider to determine if your plan covers pelvic floor therapy.
Does Medicaid cover pelvic floor therapy?
Absolutely! It’s great news for new moms that pelvic floor therapy could be getting a boost from Medicaid. Thanks to the “Optimizing Postpartum Outcomes Act” (H.R. 8181 for those who like details), introduced with support from both sides of the aisle and backed by the APTA, postpartum care is getting the attention it deserves.
This bill aims to include pelvic floor therapy in the services covered by Medicaid and CHIP, which is exciting. It’s not just about coverage; the bill is also keen on making sure there’s guidance on how to do things the right way, from screenings and referrals to ensuring everyone’s speaking the same language with the correct terms and codes.
Plus, if this bill gets the green light, it will ramp up education and training for healthcare professionals and new mothers on why pelvic health is super important and how pelvic floor physical therapy can help.
It’s about making those first precious months as a mom more manageable and healthier. Fingers crossed, I hope everything goes smoothly!
Here are some of the states that cover pelvic floor therapy under Medicaid:
- Alaska
- California
- Colorado
- Connecticut
- Delaware
- Florida
- Georgia
- Hawaii
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
Does insurance cover pelvic floor PT?
Public and private insurance covers pelvic floor physical therapy (PT). Insurance coverage for physical therapy charges may be lower compared to other medical costs. Medicare limits pelvic floor dysfunction physical therapy to $1,900 per year.
Insurance policies sometimes cover what providers need. Thus, locating a pelvic floor specialist who accepts insurance coverage is complicated.
Check with your insurance provider to see if your plan covers pelvic floor PT.
Does Aetna cover pelvic floor therapy?
Aetna’s pelvic floor therapy coverage may vary by plan and circumstance.
Some Aetna insurance doesn’t cover educational instruction or services, including physical therapy in academic settings. In contrast, others believe pelvic floor physical therapy (PFPT) with a physical therapist is the most conservative treatment for apical prolapse. Aetna does not cover pelvic muscle trainers or similar devices for urine incontinence because they are exercise machines and not durable medical equipment.
Some Aetna plans to enact biofeedback, but others deem it medically necessary for cancer pain, chronic constipation, fecal incontinence, and irritable bowel syndrome.
Physical treatment costs may not be reimbursed by public or private insurance, even though pelvic floor dysfunction is a major medical issue. Medicare covers pelvic floor dysfunction physical therapy up to $1,900 per year.
The plan and conditions determine whether Aetna covers pelvic floor treatment. Check the benefit plan descriptions or talk to a doctor about coverage.
How much does pelvic floor physical therapy cost?
You may need between $180 and $200 per session for pelvic floor physical therapy, plus a little more for your initial consultation. Experts declare that the pelvic floor muscle receives serious attention due to its crucial role in promoting bowel regularity, alleviating constipation, and maintaining general reproductive health.
Pelvic-floor physical treatment can cost up to $600 per session to improve bladder health.
Patients with health insurance must pay between $40 and $50 per session, with the insurance company covering the rest. Checking your insurance company’s policy and the therapist’s cost is best.
Does insurance cover pelvic floor therapy?
How long should pelvic floor therapy last?
Pelvic floor therapy duration varies and depends on the individual and the specific issue being treated. On average, it can last anywhere from 6 to 12 weeks, with a single session per week. Work closely with a physical therapist to determine the best plan for you.
When should you get a pelvic floor physical therapy appointment?
- When you feel pain during urination,
- Coughing, sneezing, or laughing might cause urine leakage.
- a strong need for frequent urination yet an inability to empty the bladder.
- bowel motions with pain and constipation.
- Pain-full sex
Does insurance cover pelvic floor therapy? Conclusion:
After doing a lot of research and looking at different insurance policies, it’s clear that insurance often pays for pelvic floor therapy. You can’t say enough good things about pelvic floor therapy, which is a safe and effective way to treat a wide range of pelvic floor problems.
In the end, if you have a pelvic floor disorder, you need to get pelvic floor therapy. You should check with your insurance company to see if your plan covers pelvic floor training. If it does, use this insurance to get the care you need to improve your quality of life.
