How North Carolinians are Saving Thousands on Healthcare

There is a new kind of healthcare in the Triangle that is rattling some cages, getting people back to doing what they love quicker and putting a LOT of dollars back in people’s pockets.  

 

The Scariest Question Asked

When a person calls to inquire about this new kind of Physical Therapy, they want to know if we can help them get out of pain and back to what they love to do quicker.  The answer to this is often, “of course!”

There is another question that is often asked too.  This question is one of the most dreaded questions I have to answer on a daily basis because I am forced to tell people the truth.  

When this question is asked, it is always an honest person asking an honest question.  Unfortunately, the question comes from a place of a lack of information.  The healthcare system has been designed to be ridiculously confusing so that you, the consumer, can’t figure out what you are being charged and why.  

Shoot, I’d say 90% of Physical Therapists can’t tell you how much a session will cost with them!  That’s insane!  

Can you imagine going to dinner, ordering a burger without anyone being able to tell you how much it costs and then giving you a bill for $400?  I am pretty sure that place would be out of business in the blink of an eye!  

So why is this OK in healthcare?

OK enough waiting…here is worst question I get asked on a daily basis.  

 

The Real Question You Should Be Asking

The question always asked is, “do you take my insurance?”

The answer to this question on the surface is a simple yes or no answer…that is, if the person asking it truly understood what insurance was and how it works.  

The real question that they should be asking is “would using my insurance be the most cost effective and time saving way to get back to what I love to do?”

When you truly understand the truth of what insurance has become in the healthcare industry, you will be ahead of the average consumer of healthcare by leaps and bounds and be able to save thousands on your healthcare expenses. 

 

The Truth

So here we go…here is the truth.  If you’re not ready for it, please stop reading here.  But if you are, more power to you, I am excited for the doors that are about to open for you!

We all pay insurance premiums.  For a family of 4, oftentimes it will eclipse $15,000 per year.  You’d think this would get you something for your money, right?  Seems reasonable to expect something in return for the equivalent downpayment on your starter home or a new car.

Unfortunately, those premiums only help you once you hit your deductible.  

If you have a $3,000 deductible, you have to spend an ADDITIONAL $3,000 on top of that $15,000 each year before insurance does anything.

Read on, it gets worse…

In addition, because you are using your insurance, the average cost of a Physical Therapy session in North Carolina will cost you $250 a pop.  PLUS you will have that pesky Co-pay.

What the heck is a co-pay anyways?  

It is an agreed amount between your insurance company and the provider that the provider is REQUIRED to collect by the insurance company and it DOES NOT count towards your deductible.  For many plans, the deductible is $75 or even higher just for walking into the provider’s doors.  

So…you pay $15,000 each year, plus $75 each time you go, PLUS $250 each visit until you spend $3000.   If you’re a math person, that is $18,900 that you have to spend each year BEFORE your insurance kicks in!!  (12 visits at $250 each + $75 copay each visit = $3,900)

Once you have spent almost $20,000, now you get the help of your insurance…FINALLY!

But wait, there’s a catch…shocker!  It will only help you pay maybe 70% of that $250 each session (if you have a 30% co-pay).  PLUS you still are 100% responsible for the $75 co-pay.

Once you reach your out of pocket maximum (which would take an additional 40 visits at this rate if it was $6000) then your insurance will actually pay for your care.

 

Why You Shouldn’t Use Insurance

If you’re not lost yet, in this common example, to reach your out of pocket maximum of $6000 you had to spend $15,000 in premiums, $6,000 in therapy costs and $3,900 in copays for a grand total of $24,900!!!

This is why insurance is often times NOT the best way to go financially.

Oh, and many insurance companies will only let you have 20-30 visits per year and then they stop paying.  So if you have surgery and need to go to therapy 2-3x/week you are out of sessions within 6-10 weeks…most rehab protocols after surgery are 12 weeks minimum!

Now insurance does help if you have major medical issue in the hospital or otherwise.  I am not suggesting you drop your insurance all together.  But I am urging you to educate yourself, do a little math and make an informed decision for yourself and your family.

 

Insurance Free Physical Therapy

In the New PT, that is “Insurance Free”, you pay a flat $120 per session on average.  That is it.  No confusing costs that sometimes count and other times don’t.  The cool thing is that oftentimes, insurance will actually reimburse you 50% or more too!  

So your total cost per session could be less than your copay if you used your insurance!

The other nice things about Insurance Free PT are that you get a full hour 1 on 1 with your therapist instead of sharing them with 3 other patients.  The therapist no longer has their hands tied behind their back by insurance companies with whom their reimbursement contract is with.  Their contract is now with you.  They can do whatever it is that you need to get better quicker.  

In the old model, if they wanted to use Dry Needling, for example, they would have to charge you an ADDITIONAL fee to do it because Insurance companies won’t pay them for it!  Even though it is one of the most game changing techniques out there today, insurance companies won’t pay therapists to use it…leaves you scratching your head, right?

I hope this introduction into the New PT that is storming the Triangle puts some questions in your head.  I hope it sparks some serious thought the next time you have an ache or pain or even find out you are needing to have surgery. 

You don’t have to go to the therapy place your doctor recommends.  You don’t have to go anywhere.  You are the consumer.  You have the right to do your research and figure out what the best option is for you and your loved ones. 

Stop wasting time and money.  Get better care at less cost!

If you have more questions about Insurance Free Physical Therapy contact us so we can answer all your questions for you.  We’ll even tell you how much it costs! Go figure…

"Par4Success' methods of improving swing speed (more distance!) and golf swings through improving body movements is a rare blend. He is a physical therapist with a great understanding of how the body works in a golf swing."

Jonathan Brimfield

Chapel Hill, NC

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