We know insurance can be confusing, so selecting a plan can be difficult!
Hopefully this BORING but VERY IMPORTANT blog helps you with selecting a Health Insurance plan that is best for you! 😁
Most health insurance plans restart January 1st of each year. This means your deductible, out-of-pocket, and visit limits will reset. So your cost for seeing medical professionals in January may be different compared to when you saw a medical professional the month before in December. Furthermore, some individuals will have a completely new insurance plan for the new year. It is the patient's responsibility to let providers know if and when their insurance changes. Not informing your provider can lead to medical expenses you were not expecting (due to denials or rate changes), but you as a patient are still responsible for. So please inform us of your 2025 health insurance before the end of 2024 so we can begin updating our system! This way there are no surprises on either ends!
- If you have Medicare, a Medicare Replacement, VA, an Out-of-Network insurance, or a Healthshares/Metashare Insurances, then you can continue to use your same insurance and your price should not change in the new year.
- If you have an option to select a Blue Cross Blue Shield Plan, then you will want to be extra mindful of the plan you select!
- Copay Plans are the BEST plans to have! Monthly premiums may be higher than deductible plans, but medical costs are always WAY cheaper for the patient. So if you go to any medical profession during the year with these plans, then you will have already saved money over the course of the year by having a copay plan vs a deductible plan. Even if you just came to PT for just 2-3 visits! With copay plans, you are saving an average of $50-80 per PT visit compared to deductible plans! So, if you have the option for a copay plan, definitely go for it!
- If you select a deductible & co-insurance plan, then you have to pay the full amount of medical expenses until your deductible is met. Once you have met your deductible, then you only have to pay a percentage of those expenses (co-insurance).
- A low deductible plan will have a higher monthly premium than a high deductible plan, and may cost the same (or less) than a copay plan. With a low deductible plan, if you plan to have a few medical expenses, then you will meet your deductible faster and spend less money overall in the year compared to a high deductible plan. If you came to PT for just 2-3 visits after you have met your deductible, then you will have already saved money over the course of the year by having a low deductible plan vs a high deductible plan.
- A high deductible plan will have a lower monthly premium compared to all other plans. However, it is very unlikely you will meet your deductible unless you have something major medical happen. If you need any medical treatments, you will pay more over the course of a year with these plans compared to a copay or low deductible plan. If you do choose a high deductible plan, usually it is better to self-pay for medical expenses since self-paying is cheaper than using your plan's benefits. Self-paying for medical expenses can not be applied to your deductible; however, meeting your deductible is unlikely to begin with for high deductible plans. These plans are good for people who will not need anything more than regualr check-ups with their Primary Care Doctor.
- Regardless of your deductible amount, it is always best to meet your deductible in the start of the year, so everything medical is cheaper for the rest of the year! You end up saving more money in the long run compared to waiting to meet your deductible at the end of the year or self-paying. We hear from many patients that they wish they met their deductible earlier in the year so they could have had cheaper medical expenses for more than a few months at the end of the year. So get your physical therapy in sooner rather than later! But also, try to get in any other medical expenses in the start of the year (i.e. dermatology, yearly check-ups, etc.) so you can meet those deductibles sooner and have your insurance start working for you sooner!
If you have pain or limitation and live in Greenville-Spartanburg SC, then call the rehab experts at Purposed Physical Therapy at (864) 881-1712 or you can fill out our New Patient Form by clicking HERE and we will call you!