Items to look for in your insurance plan:
-
Is there a separate benefit for rehabilitation vs habilitation or is it combined?
-
How many visits do they allow in a calendar/plan year?
-
Is this what they consider a hard max or will there be an option to request more once these visits are used?
-
Is authorization required?
-
If yes, do they determine how many visits I get ongoing even though there might be 60 available? i.e. Evicore
-
-
What are the Deductibles & Out Of Pocket Max or is there just a set copay?:
-
Are they combined in-network and out-of-network or separate? Compare across all options of plans and figure out what best fits your family’s budget when you think about how many visits your child may be using in the new year.
-
-
Are there any Exclusions:
-
Many Insurance companies have exclusions that are specific to diagnosis codes and only covered if related to, for example, Autism or Not covered if related to Developmental Delay etc.
-
Always take notes at the end and ask is there a reference number for this call? What is your name? And make sure to write down the date and time of call. Stash away for potential future use.
Remember… Keep us in the loop!
If your insurance plan changes, alert INSPIRE PT ASAP.
If there is a need for authorization this will secure that we have a chance to request approval prior to your visit. Most insurance companies do not approve RETRO requests. Once we receive your new plan info, we will check this benefit and give you a quote based on estimated allowed amounts for services to help you better understand what you may spend a year.
