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Author Topic: Inurance and PT  (Read 950 times)

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Offline gcaz

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Inurance and PT
« on: April 19, 2005, 10:18:40 PM »
Hi all,

Going in for my ACL recon tomorrow and am having a crisis with my insurance and PT.  First, I realized I have a $30 co-pay for *each visit*.  Ouch!  Now I also find out that the PT providers for Pacificare are very limited, and none seem to have the focus on sports rehab that I want.  None are ones the OS recommended to me.  Novacare seems the main contractor, with three offices in Tucson, where I live, and they didn't seem to know what an ACL was when I asked questions about there rehab protocol.

My quesion: anyone have ideas about how to force Pacificare to let me go where the doctor thinks I should go?  This is my biggest worry right now, more than the operation iteslf.

Thanks in advance for any help!
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2/20/05 - Ruptured ACL skiing
4/20/05 - ACL reconstructed using hamstring autograft

Offline beckyc

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Re: Inurance and PT
« Reply #1 on: April 20, 2005, 03:31:33 AM »
Are you HMO, PPO...  What kind of plan is it. And have you talked directly to your insurance because sometimes you have an office visit copay, but alot of times PT is not considered an office visit.
Good Luck,
Becky
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Offline gcaz

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Re: Inurance and PT
« Reply #2 on: April 21, 2005, 02:16:25 PM »
Quote from: beckyc on April 20, 2005, 03:31:33 AM
Are you HMO, PPO...  What kind of plan is it. And have you talked directly to your insurance because sometimes you have an office visit copay, but alot of times PT is not considered an office visit.
Good Luck,
Becky

Yes, I spoke to Pacificare ("Patheticare," as one staff person called it).  I'll double/triple check on the co-pay, but it seems pretty certain I'll pay each time I go.  I think the worst thing is how limited they are in where you can go.  Really only one place: Novacare.
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2/20/05 - Ruptured ACL skiing
4/20/05 - ACL reconstructed using hamstring autograft

brattkids2

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Re: Inurance and PT
« Reply #3 on: April 21, 2005, 08:11:05 PM »
I hate insurance companies!! They seem to know whats best for you without seeing you!! Ok sorry for that quick vent.

I too have  co-pay with my PT $10. Its amazing how they can limit you so much on where you can go to get the help you need.
I went to the first 3 PT sessions to get the exercises that I needed to do. I explained to my PT that I just couldnt afford to pay for each visit. (I was scheduled for 3 times per week for 6 weeks 4 times last year this would have cost me too much) She helped by giving me detailed pictures and explanations of what I needed to do. I joined our local gym for a year ($199) and use the weight equipment there. I was able to pay in payments at the gym also. Mabey you could try something like this?/ Just a thought

Best of luck to you

Paulette
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