Insurance coverage for Chiropractic and Physical Therapy at Esprit Wellness: Will my insurance pay? How much?

It may be open enrollment time for your insurance, and you may want to switch carriers for optimal coverage.   But how do you compare policies and pick the one that supports your families healthcare needs. Below Top 6 questions to ask your prospective carriers to enhance you coverage for Chiropractic and Physical Therapy Care at our clinic, Esprit Wellness Chiropractic & Physical Therapy.

1. Does the policy provide for Out of Network Coverage for Chiropractic and Physical Therapy Care? If No, STOP.  No Out of Network benefits means your provider will not reimburse you for any portion of your care.  (Translation: YOU pay 100%).  If Yes, Great!  Continue.

2. What is my deductible (This is the amount of money you pay before your carrier begins to reimburse/cover your out of network medical expenses)

3. Are there any Chiropractic and Physical Therapy limitations? Sometimes policies are very restrictive.  Ask if there are any Dollar amounts, or visit limitations.

4. What is the amount of the reimbursement?  Policies vary.  I have seen reimbursements rates vary from 30% – 100%(!). That makes a difference.

5. Is the policy/reimbursement schedule based on Medicare/Medicaid fees? or Reasonable and customary?  Big difference.

6. Can Chiropractic and Physical Therapy be performed on the same day by separate providers (i.e. a chiropractor and a Physical Therapist)

Visit www.espritwellness.com or call 212.354.2020 to speak with one of our service staff to support you better as you try to make meaning of policies in front of you!