Understanding your insurance for physical therapy

At Prime, we are committed to making your physical therapy journey as smooth as possible, including navigating insurance and payment options. We work with a variety of insurance providers to ensure you receive the care you need. Below, you will find a list of accepted insurance plans and helpful information to understand your coverage.

Insurance FAQs

We believe in transparency and want to help you understand the financial aspects of your physical therapy treatment. Here are some common questions and answers regarding insurance and payment at PRR.

Which health insurance plans do you accept for physical therapy?

We accept a wide range of health insurance plans, including: Blue Cross Blue Shield, Blue Care Network, UHC, Priority Health Plan, Cigna, Aetna, Multi Plan PHCS (Claritev), Medicare, Medicare Advantage (any previous commercial plans listed), MedRisk, and Auto insurance for accident-related care.

Do you accept Medicare Advantage plans?
Yes, we accept Medicare Advantage plans. If your Medicare Advantage plan was previously a commercial plan listed above, we likely accept it. Please feel free to call us to confirm your specific plan.

What should I know about using auto insurance for physical therapy?
If your physical therapy is a result of an auto accident, we can work with your auto insurance provider. Please bring all relevant accident and insurance information to your initial appointment.

How can I confirm my insurance benefits before my appointment?
We recommend contacting your insurance provider directly to verify your specific physical therapy benefits, including co-pays, deductibles, and co-insurance. You can find their contact information on your insurance card or their official website.

Is there anything else I should know about payment options or costs?

If you are unsure of what your co-pay or co-insurance will be, you can always call your insurance provider directly. They will be able to tell you this information. While Prime strives to assist with understanding costs, claims take time to process after being submitted, so we may not have the immediate answers for you.

What is the difference between co-pay and co-insurance?

A co-pay is a fixed amount you pay for a healthcare service every visit unless you meet your maximum Out-of-Pocket cost. Co-insurance is your share of the cost of a healthcare service, calculated as a percentage (e.g., 20%) of the allowed amount for the service. You typically pay co-insurance after you've met your deductible.

Do I need a referral from my doctor for physical therapy?

Michigan is a Direct Access state. You are allowed to see a Physical Therapist for 10 visits or 21 days prior to requiring a referral. If you require more visits, then you will need a referral or signature on a Plan of Care given to the Physician by your Physical Therapist.

What if my insurance plan is not listed?

Even if your insurance plan is not explicitly listed, you may have Out-of-Network benefits. This will likely require prior-authorization on our end to treat you. We are always exploring options to work with new providers and can help you understand your out-of-network benefits or discuss alternative payment arrangements.

Ready to start your recovery journey?

Don't let insurance questions delay your path to wellness. Prime Recovery and Rehabilitation is here to help you understand your benefits and get started with personalized physical therapy care.