Health Insurance Co-Payment Increases

Some health services bring great benefits to patients. Physical therapy is one of them. During a patient's hospital stay after surgery or injury, physical therapy is often the first step toward a person's road to recovery. Once they go home, therapy continues to aid the patient's full recovery. But some health insurance companies are raising the co-payment rates for outpatient physical therapy services and freezing out its policy holders from getting the care they need.

Once a patient is discharged home from the hospital, they may require additional physical therapy to make sure they recover safely and correctly. The goal is to return the person to their prior level of activity (or better) before the hospitalization and to make them as functionally independent as possible. The therapy may take place in an outpatient setting or in the patient's home, depending on the patient's level of activity and mobility.

For instance, many patients who have a total knee replacement surgery require several physical therapy sessions after hospital discharge to help increase knee range of motion (bending and straightening) and strength. Without it, they never regain full mobility and flexibility.

Physical therapy has shown outcomes that reduce a patient's need for medications, imaging, injections and surgery. This saves the health insurance company more money in the long run.

In New York State, physical therapists have been classified as specialists by health insurance companies and therefore the co-payments have risen to specialist rates. It makes it impossible for some patients to afford the $50 or $60 or $70 co-payment 2-3 times a week. It seems like these companies are going to be losing more money in the long run when their patients have to return for additional medical care that could have been reduced or eliminated through the help of physical therapy. New York State physical therapists are going to Albany to fight for new laws that will reduce a patient's co-payments for services.

Before buying individual health insurance, make sure you read and understand all the benefits, deductibles, co-payments, and premiums that go along with the medical plan.