Medigap: Physical Therapy Coverage Explained

Our Medicare eligible clients contact us regularly questioning how Medigap covers physical therapy after an injury. To keep you informed, here is a quick senior65.com tip...

Does Medigap cover physical therapy after an injury? Rather than wait until an emergency happens, we have detailed below how Medigap covers physical therapy.

Medicare’s Physical Therapy Coverage

Until Feb 9, 2018, Original Medicare had a combined cap on physical and speech therapy each year of $2,480. The US Senate recently voted for language that permanently repeals Medicare’s maximum payout caps. The best news is that the new change is effective for all claims back to January 1, 2018. Those with Original Medicare without Medigap will still be required to pay the part B deductible, 20% of the office visits and 100% of any excess charges.

What Medigap Pays for Physical Therapy

If you seek physical therapy, the majority of Medigap plans will cover 100% of your copays and coinsurance*; however, only Medigap Plan C and F covers both your Part B deductible. Additionally plan F and G cover your Part B excess charges.

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*Plans K and L make you pay 50% and 75% of these costs, respectively. Plan N requires you to pay a $20 copay per doctor’s office visit.

For help finding a Medigap plan in your area call one of our licensed independent insurance agents at 800-930-7956.

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