Insurance & Coverage FAQs
Is in-home physical therapy covered by insurance?
Yes, in-home physical therapy is typically covered by Medicare Part B when it is determined to be medically necessary for your rehabilitation and recovery.
What costs should I expect?
Costs depend on your specific insurance plan and deductibles. For patients with Medicare Part B, you are generally responsible for 20% of the Medicare-approved amount after your annual deductible has been met.
How many visits does insurance cover?
The number of visits covered is based on clinical medical necessity and your insurance provider’s specific policy guidelines. We work closely with you and your insurance to optimize your care plan.
What does ‘medically necessary’ mean?
Medical necessity refers to services or supplies needed to prevent, diagnose, or treat an illness, injury, or its symptoms according to established medical standards.
Do I need a doctor’s referral?
While Connecticut provides direct access to physical therapy, most insurance companies require a primary care physician’s referral or a signed plan of care for billing and continued service authorization.
What if my insurance is out-of-network?
We can discuss private pay arrangements so you can access the specialized care you need regardless of your direct provider coverage.
Can my insurance benefits change?
Yes, benefits often reset or change on an annual basis or if your plan’s parameters are updated. We suggest checking your benefits at the start of every calendar year.
Should I verify my insurance benefits?
Absolutely. Verifying your benefits before starting treatment is the best way to avoid unexpected costs. Our office is here to facilitate this verification for you.
Can I still receive therapy without insurance?
Yes. For those without coverage or seeking wellness services that fall outside of medical necessity, we offer private pay options to ensure you can continue your health and wellness journey.
What makes in-home therapy different?
In-home therapy offers the same high standard of clinical care as a facility but delivered in your living environment, focused on functional goals relevant to your daily life and home safety.
Need Help Understanding Your Coverage?
We’re here to make it simple. Call or Text RestoreLab to Verify Your Benefits & Get Started Today.