1. Co-payments:

   Medicare is an 80/20 plan, you are responsible for 20%. And, if you have a secondary insurance, the 20% should be covered.

   Aetna MC advantage is a different program and you will be responsible for a co-payment. Please call and know that amount; each plan is different.

2. Deductibles:

   Medicare: There is a $257.00 deductible each year that you must pay before Medicare will reimburse Bodylogic for your therapy. Unless you have a secondary insurance plan, specifically plan F (rare), you are responsible for that amount. You will need to pay this amount at the time of service. IF you have seen other medical practitioner(s) (your primary care physician for example), you may have already paid toward the deductible. Regardless, just know that you will be paying 257.00 to your first practitioners of the year, unless your secondary covers it.

You are also responsible for what your insurance company does not pay. Insurance companies will not pay for Massage, Dry Needling, Theraband, Exercise classes, Bracing, Taping, and many modalities. For Bodylogic, that consists of any treatment that falls under Medical Bodywork or Medical Wellness.

1. Medicare for Physical Therapy can only be used if you have functional deficits. If you can not turn your head to drive, can’t stand long enough to cook, can’t walk essential distances, can’t take the trash out, can’t sleep, etc. It can not be used for personal training or massage techniques. We have two other programs for this type of therapy—Medical Wellness and Medical Bodywork.

2. I do not exceed the $3000 threshold for Medicare in a calendar year. This comes out to about 23 PT appointments for the year. It is important to conserve appointments in case there is an issue later in the year. For more chronic issues, for scheduling purposes, I typically see patient for 4-6 weeks for one round of therapy.

I offer 1 hour of treatment. That includes transition times, changing clothes, scheduling etc. So, the more of that you have done when you get here, the more time for treatment. Remember that you can do all of your scheduling and maintaining a presence on the schedule at Bodylogicnc.com. However, know that Medicare only pays for 53 minutes of treatment in one session.

You can submit a claim for reimbursement for insurance plans that I am NOT IN-NETWORK with, and I will provide you with paperwork with insurance codes to accompany your claim. Currently, I am not in network with Blue Cross and Humana. My patients who do this, have reported that it is not challenging to be reimbursed.

HSA cards can be used for the cost of Physical Therapy care, Medical Wellness, and Medical Bodywork. Be sure to check with your plan for verification of coverage.