Met your health insurance deductible in Kansas City? For most patients, meeting your insurance deductible before the end of the year means the most “bang for your buck.” However, it’s also an excuse to check with your doctors.
If you’ve been delaying a visit to a physical therapist, chiropractor, or other medical professional, now is the time to do so. Many patients put off appointments until the end of the year. Then, they feel rushed to get in with their doctors in time to meet their deductible.
Not sure how deductibles work? The team at F.I.T. Muscle & Joint Clinic is on a mission to change the landscape of the healthcare industry. Read on to learn more about how to meet your health insurance deductible in Kansas City.
What is a deductible? How does a deductible work?
Many insurance companies and insurance plans have a deductible built in. This is a minimum amount you have to pay in fees, procedures, treatments, and other medical expenses per year before insurance kicks in and covers the rest.
Deductibles can range anywhere from $0 to upwards of $10,000. You can find the amount of your deductible on the payment summaries your health insurance company sends you in the mail; your online account; or by calling the number on the back of your card.
The idea is to save you—and the insurance companies—money by promising a minimum spend each month. This keeps your insurance rates down and prevents your health insurance coverage from being exceeded in a calendar year.
However, in reality, that often means that patients wait until the end of the year and then realize that they are either close to reaching their deductible or have just exceeded it—which means that any healthcare costs incurred for the rest of the year are covered!* So if you're like many of these patients, read on about how to meet your health insurance deductible.
What’s the difference between a deductible, co-pay, and out of pocket maximum?
A deductible is...
The amount you’ll need to pay out of pocket before your insurance will kick in. This includes all billable items like doctors fees, co-pays, etc. However, once you meet your deductible, you may still be responsible for paying for certain costs accrued, depending on your insurance. Usually this is around 20% of the cost of your care.
An out-of-pocket maximum is...
The highest amount an insurance company dictates that you should have to pay for all covered services in a plan year. This means that after you hit your out-of-pocket maximum, you will no longer need to pay for any health expenses that are covered by your benefits. All you’ll pay is your monthly premium.
For example, let’s say that we have both a deductible ($1,000) and an out-of-pocket maximum ($1,500). When you reach your $1,000 deductible throughout the course of the year, the insurance company will begin to make payments and cover additional expenses on your behalf going forward, up to 80% of the total costs you’ve accrued. You will receive a bill for the other 20%. (Sometimes this bill comes from the provider; other times, your insurance plan will pay your doctor in full and send you a bill themselves.)
Once you reach a total spend of $1,500—the other $500 being from those 20% payments we just mentioned—your insurance company may take over and pay the remainder of any new costs incurred.
A co-pay is...
The initial cost of an ER or office visit. You should see your co-pay amounts listed on your health insurance card. Most insurance companies consider physical therapists and chiropractors as “specialists,” which they consider as a separate type of doctor than “primary care.”
The rule of thumb is...
Not all plans have deductibles, but most plans have an out-of-pocket maximum. Be sure to check all of your insurance coverage closely, especially before making any appointments. It’s never fun to arrive at a doctor’s office and discover you’re responsible for paying fees you weren’t expecting, and if you ever have questions the staff at F.I.T. Muscle & Joint Clinic is happy to look into your benefits prior to your appointment!
It’s important to note that often times, health insurance companies will only count payments you make to in-network providers towards your deductible or out-of-pocket maximum. You should be able to find a list of in-network providers by checking your health insurance company’s website or by giving them a call before your appointment.
Many times, if your primary care doctor gives you a referral, they can check this status for you to ensure specialty services are covered.
What insurance companies does F.I.T. accept?
F.I.T. Muscle & Joint Clinic is in-network with:
- Blue Cross Blue Shield
- Freedom Network
- United Healthcare/UMR
Additionally, we can work with your auto insurance if you’ve been in an accident. Learn more about the costs & financing of your upcoming physical therapy appointment.
Can I use Obamacare for physical therapy?
The ACA (Obamacare) prohibits insurers from imposing dollar limits on coverage for essential health benefits (so an insurer cannot, for example, limit rehabilitative care benefits to $1,000 per year). However, insurers often impose limits on the number of visits.
Insurance Physical Therapy Limits in Kansas City →
If PT is considered medically necessary, and you find a provider that’s in-network with your specific insurance plan, you should have no problem getting health insurance coverage for physical therapy.
Should I use my HSA/flex spending account for physical therapy? →
Do I have to pay for my health insurance deductible upfront?
While there may be an occasional exception, most insurance companies we’ve encountered at F.I.T. Muscle & Joint Clinic require that you meet your deductible upfront before their coverage will begin. This is why most people rush to book a physical therapy appointment before the end of the year—they finally hit their deductible and would like to take advantage of better coverage before the new year starts.
Do I need to use insurance for physical therapy?
Contrary to popular belief, our services are affordable even without health insurance coverage! Simply give us a call and we’ll be happy to walk you through our fees and payment process.
Benefits of meeting your deductible with F.I.T. Muscle & Joint Clinic
There are a variety of options available to you to receive physical therapy in Kansas City. If you're looking for how to meet your health insurance deductible in Kansas City, we can help.
Here’s why we believe F.I.T. Muscle & Joint Clinic is your best choice.
F.I.T. Muscle & Joint Clinic makes it easy to get the care you need. So easy that you’ll run out of excuses not to go! When you work with one of our providers, there are no hidden fees, and all services are included. We promise to always be upfront with our clients, because at our core, we believe in putting patient care first—not profit.
Experts in our field.
Our physical therapy clinic in Kansas City believes the secret to success is to not only encourage our patients to move more but to encourage them to move better for long lasting results. We utilize a variety of tools such as dry needling, Graston, active release technique, Kinesio taping and dynamic neuromuscular stabilization to correct the dysfunction within your body.
We stress the importance of continuing education to ensure all of our doctors and therapists are current with the most up to date literature and techniques, allowing increased success in treating the difficult conditions we encounter in our treatment rooms daily.
Multiple Convenient Locations.
F.I.T. Muscle & Joint Clinic currently has 8 convenient Kansas City locations (with plans to grow!) to accommodate your busy lifestyle. Any team member at our Lee’s Summit, Blue Valley, Crossroads, Overland Park, Shawnee, Kansas City, Olathe, or Liberty clinic will be happy to help with anything you need.
Health on a Budget.
Chiropractic care and physical therapy have been proven to be the most cost-effective method of eliminating neck and low back pain. This is often true of other conditions as well. The average cost of imaging (X-rays, MRI’s, etc), medications, and surgeries often far surpasses the costs associated with manual care. And conservative options should always be exhausted prior to surgery.
If you’re having initial concerns for your health, chiropractors and physical therapists may be able to help address problems before they become full-blown medical issues. We can set you up for long-term success by giving you the tools and knowledge you need to stay active and keep your body engaged and moving.
Meet Your Deductible. Make Your Appointment.
At F.I.T. Muscle & Joint Clinic, we want to help you return to your busy, active life as soon as possible—feeling even better than before. By providing accessible service and personalized care plans, many of our patients tell us we’re on the right track.
If you are hoping to or about to meet your health insurance deductible before the end of the year, or need more information about how deductibles work, please don’t hesitate to contact F.I.T. Muscle & Joint Clinic. We’re happy to be a resource to the Kansas City community. To help you navigate the sometimes confusing world of physical therapy and chiropractic care.
You can also use our Virtual Consultation tool to discover which treatments may work best for the pain you’re experiencing.
*Check with your individual insurance company for more information about your deductible. You can also ask them about any other questions you have about your insurance coverage.