Happy New Year from TAG! With the new year comes a new year for insurance plans and the team over at TAG wants you to be able to understand your benefits as best as possible. We have already introduced to you what a deductible is and how that applies to your insurance plan so we wanted to answer some other questions you may have regarding your insurance plans and how they work. Read on to learn about copay and coinsurance as well as how to find out how many visits from insurance allows toward physical therapy.

What’s the difference between a copay and a coinsurance? A copay means that a patient is responsible for paying a flat, set amount for a particular health service, regardless of the amount billed. For example, doctor visits or physical therapy visits may be covered by the insurance at 100% as long as a patient pays a copay amount of $20 per visit. If a patient does not have a copay, they may be responsible for a portion of the total cost of the visit, also known as coinsurance. Coinsurance is your portion of the costs of covered medical services, which is typically calculated as a percent. For example, if your coinsurance is twenty percent, you would pay $20 on a $100 medical bill and your insurance would pay $80.

How many visits am I allowed to come to physical therapy for?
The world of insurance and medical benefits can be daunting to understand but it is becoming increasingly important to know what your insurance company offers and how to best utilize your benefits. Our staff at TAG checks your insurance benefits throughout your time with us but it is also important for you to double check your insurance and be aware of the number of visits for physical therapy you are allowed and to keep track of how many you have used. Unfortunately, your visits are not unlimited. When speaking with the insurance companies there is specific verbiage to use to get the correct information. To obtain benefits specific to our clinic, ask the representative for out patient physical therapy benefits in an office setting. If you’re just concerned about the number of visits allowed, let them know!

Still unsure of what these benefits mean or how to interpret them? Give us a call and we’ll be happy to help!