health insurance

What Will Insurance Cover?

Back pain is an increasingly common problem that affects people all around the nation. Since so many of their customers suffer with back pain, insurance companies often provide some sort of coverage for it’s treatment. Although each company’s coverage may be slightly different, there are some back pain solutions that are usually completely, or partially, covered by insurance.

Pain medication

Many insurances will cover some or all of the cost of prescription pain medications to relieve back pain. While most back pain sufferers can receive the medication, there may be limitations on how frequently it can be refilled based on what your doctor chooses to prescribe and what the insurance company will approve. Depending on the type of medication given for the pain, you may need to visit a doctor every few months to keep the prescription active or even each time you need a refill.

Physical therapy

Physical therapy can be used to help relieve back pain by reducing swelling, improving range of motion and increasing strength. While insurance plans frequently cover the cost of physical therapy, they may only cover a specific number of sessions. Check with your insurance provider before beginning therapy to find out if they will continue coverage for as long as a doctor recommends or if you are only covered for a few sessions.

Injections

Injections are a very common way to relieve chronic back pain and therefor most insurance companies include them in their coverage. Some companies limit the number of injections that can be received in a single session or only cover the use of specific medications and steroids.

Surgical procedures

Procedures that are considered minimally invasive (usually same day or out-patient procedures) often have most of their cost covered by insurance companies. If your deductible is high, you may still pay hundreds or thousands of dollars out of pocket as any type of surgery tends to come with a high price tag. More complicated surgeries, that could recover days of recovery time, can be often be challenging to get covered by insurance and may require extra documentation for approval.

Getting the coverage you need

When seeking relief for your back pain, find out what your insurance company needs to approve treatment. Do you have to see a certain doctor? Do you need to get prior approval from the insurance company? Do you need a referral to visit a specialist? Finding answers as soon as you can allows you to move forward with confidence and can help prevent unexpected medical bills.

If you get denied

If your insurance company denies coverage, don’t be afraid to keep asking. Often times insurance denials are the result of a clerical error or a miscommunication between the doctors office and the insurance company. Sometimes a claim can be approved by simply changing the way the request is worded. Talk to your doctor’s office about appealing insurance denials and what they recommend. Insurance companies handle claims all day long, so there are bound to be some mistakes made and your doctor’s staff has the knowledge and experience to help you appeal.Many offices will start an appeal as soon as they receive word that a request has been denied.  Be sure to keep records of every part of your treatment. Your medical records, receipts, correspondence with doctors and the insurance company, everything. These records will be helpful when appealing an insurance denial and can be used to dispute any incorrect billing that may occur.