“Do you take my insurance?” This question comes up a lot. And when I say a lot, like, it’s almost every time I talk to someone.
For some reason, Americans have been so accustomed to make sure that whoever they go to in healthcare that the provider “takes their insurance.” I think that most people feel that since they are paying their monthly premium, which is usually expensive, that they should stay in network to save money. But is it really saving money?
Usually you would still have a copay or coinsurance when you walk in the door. And guess what? The provider does not receive extra money because you are paying a $40 copay. That money comes out of the total. So who really wins here? The insurance company! Not only are you paying your monthly premium, but you are also paying for half or sometimes more than half of the visit charge! That’s insane!!!!!
Your insurance company scares you into staying “in-network” because it benefits them. The insurance company is not looking out for you, they are looking out for themselves. They scare you because it saves them money. And this is a multi-billion dollar industry. That’s right, I’m not talking about health care, I’m talking about the damn insurance companies!
What if I was to tell you there is another way?
Did you know that most health insurance plans have out of network benefits? Did you know that you can actually get reimbursed a good chunk of money if you go to an out of network provider? You probably didn’t know this because the insurance companies have been tricking and scaring people for years now!
So here’s the deal: No, I do not take your insurance. Yes, I do work as an out of network provider. Yes, you could get reimbursed for some of the visit cost but that depends on your insurance carrier and plan.
Oh, and did you know that you can use your HSA/FSA to pay for physical therapy? Most people do not know that either!
So the upfront cost to see a real physical therapist is more expensive but it may actually save you money in the long run. And on top of that, you get actual one-on-one care with the physical therapist and you don’t work with anyone else!
Let’s look at an example:
You have a $40 copay. And you go to a traditional clinic. They want you to go 3 times a week. So that’s $120 a week you are paying out. Each time you go, you are spending about 15 minutes with the PT. Then you do some exercises with an aide. Then you lay on the table and get ice and electric stimulation (which does nothing by the way). So in total in the week, you are only working with the therapist about 45 minutes but for some reason you spent 3 hours in the clinic. That some reason is because these clinics charge units and make money by you “working with the aide” (which is illegal) and putting useless modalities on you.
With an out of network provider you get charged up front. For me, you pay $179 a visit. But…sessions are once a week. You only see me, the physical therapist. And I work with you for a full hour. Then you get the option of paying with your HSA/FSA and on top of that, can get reimbursed for part of your visit when you submit to your insurance company.
So you were paying $120 a week and only getting 45 minutes of care with the PT. With me, you have $179 a week but you get 60 minutes of care and then you can get reimbursed for part of your visit.
120/45 = 2.66 dollars per minute
179/60 = 2.98 dollars per minute
But, remember you can get some of that money back! And on top of that, I saved you 2 hours of your life by only having PT once a week. And I came to your house, so I saved you even more time and money!
And guess what? If you have questions, with me you can call or text me. And I will answer! In the traditional clinic, you do not get that service because you are just a number and billable service to them.
So next time you ask “do you take my insurance” start thinking like a more informed consumer. Start asking “is this worth my time and money” and “what is the quality of care I will receive.”