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Health Insurance Won't Cover PT

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  • Health Insurance Won't Cover PT

    So after 3 trips to the physical therapist, I learn my health insurance won't cover physical therapy unless it's after a trip to the emergency room or surgery... I was getting a lot out of it. Anybody have any solutions for this?

  • #2
    I don't have an answer for you about your insurance. But did the physical therapist have you do any stretches or anything you can do at home until you can get it sorted out?
    Don't give up find out just what they want you to do and do it. I wish you the best. I am having some insurance problems too but we are working them out



    • #3

      "Unless it's after a surgery."

      Has your urologist done a hydro or a cysto surgery? Usually if a doctor examines you and documents that you absolutely need physical therapy, the insurance has to cover it. I have had to write numerous times to the headquarters of my insurance with an attached doctor's note citing that I have to have certain medications.

      Hope it works out,

      Diagnosed with IC in 2005, since then have been diagnosed with an unspecified autoimmune disease, with inflammation in my bladder, colon, left knee, left ear, left eye, lungs and pericardium. Argh!

      Medical research addict.

      Likes: hot baths and naps with cats


      • #4
        I suggest you talk with your doctor about filing an appeal. MOST insurance companies cover PT since they have found that in many instances it prevents the need for surgery.

        Stay safe

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        • #5
          Thanks for all the responses! I hate dealing with stuff like this, but this is helpful. I do have some stretches I'm doing at home and I am feeling like they are helping, which makes it all the more frustrating that the insurance isn't covering it. I did have a cysto hydrodistention which I thought may qualify as surgery... I will talk to my doctor and see what I can do.

          To top it all off I got a ticket while driving home tonight... this is not my day.


          • #6
            I agree with trying to appeal that decision. If you get a prescription from a doctor, then PT should be covered, surgery or no surgery. It could be that the company has no idea what pelvic PT is and is making a snap judgment. Things like this frustrate me!
            34 years old, bladder symptoms all my life
            diagnosed with PFD and VV October 2009; IC May 2010

            Current meds:
            Cystoprotek 2 pills twice a day, Hydroxyzine 10 mg, Gabapentin 600 mg, Myrbetriq 25mg, Zoloft 25 mg, Mircrogestin, capsaicin cream (for vulva)
            Other past treatments:
            IC diet, physical therapy, Traumeel injections as needed, TENS unit, heating pad, instills with sodium bicarb, lidocaine, and mucosa compositum
            Tried and didn't work:
            Pyridium, Singlair, Nortriptyline, Elmiron, lidocaine and heparin instills (worked at first, then didn't anymore), various creams, acupuncture