Physical therapists are specialists – according to many Georgia insurance policies, that is.
And while physical therapists undergo extensive education, training and may be considered specialists in their profession, the “specialist” title – generally reserved for physicians such as neurologists and cardiologists – comes with the burden of high co-pays for consumers actively seeking treatment.
A co-pay is the fixed fee set by a health insurance company that patients pay out-of-pocket to medical professionals for an office visit. Specialist co-pays can often run as high as $50 to $75 for a single visit, in comparison to $22 for a primary care visit.
Physical therapy isn’t like other specialist services.
With physical therapy, a patient is typically seen multiple times over the course of many weeks, or months, meaning that patients face hundreds of dollars in co-pays in addition to the costs of their health insurance premiums.
These hefty fees tacked on top of their insurance have become a financial disincentive for many patients, restricting them from accessing therapy services and – at times – forcing patients to forego their needed physical therapy treatment altogether.
In order to further understand this issue, the Physical Therapy Association of Georgia (PTAG) conducted a survey of over 200 physical therapy patients to determine to what extent this unfair practice affects Georgia’s consumers.
For the estimated 496,000 Georgians who are in need of physical therapy annually, the results were startling. The survey found that 21 percent of respondents have physical therapy co-pays greater than $50 per visit and as high as $75 per visit. With an average of 8.2 visits per month, that can add up to $615 in out-of-pocket expenses that insured patients must pay for just a single month of treatment.
Georgia physical therapists are taking action to address this issue and helping consumers afford treatment for themselves and their families.
Lawmakers in Kentucky, South Dakota, and Missouri recently passed legislation aimed at reducing the financial burden of high co-pays by reducing them to co-pays comparable to those of primary care physicians.
Georgia legislators should recognize this ongoing problem and ensure Georgia consumers have access to the care they need – and are not deterred by excessive co-pays.