Getting Health Insurance to cover phys. therapy/private care

[shooshinboots]

Many women afflicted with this condition are forced to visit doctors and/or physical therapists outside of their HMO or PPO network because so few doctors are aware of how to treat pelvic pain disorders. Physical therapists charge upwards of $200/visit. Doctors who hold monopolies on treatment in urban areas cost a fortune ($400 for a consult).

Because these medical professionals know there are patients out there willing to pay cash out of sheer desparation, they don't take insurance.

I forked over $3000 for treatment in 6 months. Then I got fed up and called my insurance company. I have a PPO that would normally reimburse me something like 30% for out of network doctors (btw physical therapists of this sort don't even qualify). I argued with Customer Service and demanded to speak to a manager, then their manager and their nurse and explained that since none of their providers offer a service that I need BCBS is obligated to cover me.

They bought it. I now get reimbursement at 80%. Ladies, do not let the insurance industry nor the a-hole doctors take advantage of you. There is a way to get coverage, you just have to make some noise. Pelvic pain/vulvodynia is a nightmare to go through. Financial woes should not have to contribute to your pain.

I will gladly offer you more info on this matter. shooshinboots@hotmail.com

[tigger_gal]

I have had to go to pt 3 times over the last 10 years... and my insurance covered it thankfully.. You are right tho you have to make a lil noise to get any type of coverage. There are many insurances that refuse to cover PT. I really believe that it has to do with how the rx is wrote up for it..
Glad you made noise and got help with the bill.. no will they remburise you 80% of the 3 grand you shelled out? I hope so..
Brat

[csocain]

I'm so grateful that my insurance company has covered all of my PFD pt. They even paid 90% of my interferential unit! What a blessing!!!

[ICNDonna]

One thing I did find out is that many times insurance companies will pay for physical therapy through a hospital-connected physical therapist for a much longer period than an independent therapist. My husband had therapy for his back before surgery and had maxed out his coverage on an independent --- after his surgery we changed therapists to one connected with a hospital --- bingo! --- no limit on number of visits.

Donna

[shooshinboots]

Maybe there is a difference in coverage for IC than vulvodynia. Since there is so little knowledge about vulvodynia in the medical community, insurance companies have no way of knowing how to cover it (or they don't know about it at all). Most doctors from Gyns, GPs, to Urologists have never heard of it.

I appreciate your support. I was able to get reimbursed, but many women don't know they can or how.

To clarify...when I say Physical Therapy, I mean internal pressure point massage through the vagina into the uterus (like a pelvic exam), biofeedback (measures the ability to tighten and relax vaginal muscles), and floor exercises. Not your typical move the knee back and forth kind of thing. There are only 3-4 PTs in all of San Francisco that are trained to do this. They don't take insurance, b/c they don't have to.

More info on vulvodynia can be found here: http://www.nva.org