Cash-based physical therapy is becoming more and more talked-about. Here’s the truth: it can be easy to frame cash-based physical therapy as a black-and-white solution to insurance-based care, but there’s more nuance to it than that: it’s true that cash-based physical therapy offers more flexibility and more holistic solutions than most insurance-approved treatment plans. However, whether or not cash-based physical therapy is right for you depends on your lifestyle and needs. We want to make sure you have the information you need to really evaluate which physical therapy approach best fits your life. That’s exactly what we’re doing in this post – keep on reading to learn more.
A Breakdown of the Insurance Model
Knowing whether going through insurance is your best bet starts with understanding how it actually works. If you were to visualize the relationship between insurance companies and physical therapy providers, think of a decision-making hierarchy. The decisions about what kinds of treatment are covered are made by insurance providers, then communicated to physical therapists, then doled out to patients. What does this mean for patients? It means that the type of care they’re able to receive is determined by people who never actually interact with them in a one-on-one setting. It means that most physical therapy covered by insurance is reactive, or given in response to a specific injury. It also means a limited amount of sessions are actually covered, and those sessions themselves are highly targeted at a specific pain or injury, not geared towards whole-body improvement.
We know that all sounds kind of biased, but here’s the truth: if you are looking for treatment of a relatively minor injury, have no prior medical conditions, and don’t particularly care about improving your mobility or strength in a physical therapy setting long-term, the insurance-based approach might be just fine for you. However, if the idea of being confined to “medically necessary” treatment and nothing else in your physical therapy doesn’t seem like the right fit for your needs, you do have other options.
What a Cash-Based Approach Offers
Cash-based physical therapy exists completely outside of the parameters and limitations of insurance coverage, and it may be worth exploring if:
- You have a long-term pain or “problem” area that flares up every so often
- You want to contextualize your targeted treatment into a more holistic treatment plan
- You want to use preventative physical therapy to stave off certain conditions, like arthritis and heart disease.
- You don’t want to be confined to a set number of sessions
- You want the freedom to work with your physical therapist to map out what your sessions consist of.
- You get payment options. Literal “cash” is not the only option when it comes to paying for treatment; Purpose patients are welcome to use a credit or debit card, or even an FSA or HSA account.
Insurance generally doesn’t cover physical therapy treatment that is preventative, that goes on indefinitely, or that is given in response to a longstanding pain that can’t be traced back to a specific injury. If those are specifically the kinds of treatment you are looking for, or if your injury-based treatment would feel incomplete if you weren’t also getting whole-body care, it’s worth considering a cash-based model instead.
Deciding on the Best Approach for You
It’s natural to wonder: isn’t a cash-based approach to physical therapy considerably more expensive than going through insurance? The truth might be surprising.
First and foremost, it depends on the kind of treatment you want and need. Like we mentioned above, if all you’re looking for is short-term, highly targeted treatment that doesn’t focus on preventive care, the insurance-approved model is probably compatible with your goals.
However, if the treatment you need is more preventative (or at least more open-ended and holistic) than that, going for a cash-based approach can actually save you money in the long run. We say this because it’s important to consider the quality factor. If your treatment sessions are carried out according to rigid rules set forth by insurance companies, and therefore ignore some of your physical needs in order to treat one single injury, you’re likely to need more sessions. Because insurance usually only covers a specific amount of sessions, you would be stuck between a rock and a hard place: ending treatment before you’ve reached all of your goals or continuing treatment at full price. On the other hand, cash-based physical therapy is completely adaptable to your specific needs from the very beginning. As a result, you’re likely to need less sessions in order to meet your physical goals.
If you have long-term or holistic goals, it’s definitely worth further investigating the cash-based physical therapy model.
Purpose Physical Therapy and Wellness’s cash-based physical therapy approach exists to give patients options beyond rigid insurance coverage. We invite you to schedule an initial evaluation with us to get a feel for where you are and map out your treatment plan. You’re also welcome to give us a call if you’re not quite ready for an evaluation.