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PATIENT IMPACT

For many patients, high copays put needed physical therapy services out of their financial reach. As a result, they may be forced to forgo care, or choose other more invasive options such as surgery, simply because of the way in which health insurers set copay and payment levels. Here are some examples of how high “specialist” copays hurt patients.

Patient Impact

The use of high “specialist” copays for physical therapy care hurts patients. It effectively denies them access to a covered benefit under their health plan because they cannot afford it.

Below are some experiences from Physical Therapists and physical therapy patients. These testimonials advocate for the passage of a bill that limits high copays to patients.

Patient Testimonial (video)
Hi, My name is Kay and I had a knee replacement in December. I had some complications set in and I've been coming to physical Therapy for four months...

My copays for medication are cheaper than those for PT!  I simply can’t afford to pay the exorbitant cost to cover PT which is critical to my recovery.  I was recently approved for SSD, yet am ineligible for Medicare.  After having completed 6 months in a back brace.  I am unable to afford the copays for PT.  This makes NO sense.

I had a laminectomy fusion on L4 L5 in September of 2008.  I was able to start PT in March.  However, instead of the recommended 2-3 visits per week, I’m only able to afford an occasional visit with my terrific PT.  This has certainly negatively impacted my recovery.  PT is as critical to recovery as any prescription medication, yet the copay is prohibitive.

I had foot surgery in January and was prescribed PT 3 times per week at a cost of $50 cop-pay per 30-minute session.  It was cost prohibitive for me to pay $150.00 per week for PT and subsequently I went over 6 months without therapy.  Now I am doing PT just once a week but the therapist says my foot has not healed since surgery.

My surgeon recommended Physical 3 times a week for recovery from ACL Replacement knee surgery. My copay is $25 per visit. That is $75 a week! How can anyone fit an extra $75 a week into their budget? Copays are ridiculously high for Physical therapy.

I am struggling to find a solution to my health issues, as I cannot afford to pay $75 a week.  As it stands now, I do not know how to make ends meet.

After rotator cuff surgery, my doctor says I will need 6 months (3 X a week) of PT to regain the use of my arm. My "specialty copay" is $30 per visit. The same visit would cost $40 if I had no insurance, so I am paying ¾ of the cost due to "specialty copays". As a retiree, I cannot afford these charges.

I had a patient who broke her wrist and after she came out of her cast was not able to move her hand or fingers, they were very stiff and weak. She needed intensive physical therapy 3 times per week. She had to stop coming to PT after 3 weeks because she couldn't afford the copays. At the time she was not able to hold a glass of water, eating utensils, wash her hair or much more with her right hand (she was right handed). Her quality of life was severely affected.


Please join us in the fight for lower copays!

* Information on this page was taken from www.faircopays-betterresults.com, 2010