Syracuse (WSYR-TV) - In an effort to keep premiums down, many employers are choosing health insurance plans that have much higher co-pays. It's a double edged sword for many people, especially those who need physical therapy. In many cases, you're being forced to choose between what you can afford and what your doctors prescribe.
Sue Skibinski owns three physical therapy offices in Central New York. Over the past few years, co-pays for her patients have gotten out-of-control. She says that clients have to pay a wide range of different amounts from $30 to $60. Since most people require two or three visits a week, these prices quickly become unaffordable. “We've seen a significant number of patients who before would have required a month's worth of physical therapy, now they're telling me, look I can only afford to come three times, can you just do whatever you can do in 3 visits,” she said.
Sue says the high cost of physical therapy may be pushing people into unnecessary medications and surgery. One of her patients, Theresa Piering, needed repairs to meniscus rips on both of her knees. She says the treatment eventually just got too expensive. “I was coming in 3 times a week in the beginning, and then two.”
Part of the problem is that physical therapy is technically considered a specialty, so you've got to pay the more expensive "specialist" co-pay. “You go to a cardiologist and the office visit fee is $400 and the insurance company is paying $360 of it, you have to pay a $40 co-pay, so you've paid 10% of the cost of service, I don't think anyone thinks that's unreasonable,” Skibinski said.
A physical therapy visit, however, is no where near that expensive. So Sue and some of her collogues around Central New York have made cards for patients with high co-pays to fill out, and they plan on bringing them to Albany in May. They want to be given a co-pay designation of their own, or at least be moved to the "primary care" category.
Chiropractors are running into this same problem. They too are technically classified as specialist so their co-pays are much higher.
Because of how co-pay rules are written, there's really nothing that can be done until there is a change in the law. That's why providers are petitioning local politicians.
The NYS Physical Therapy Association has put together a website with more information about how they're trying to keep co-pays down:
www.FairCoPays-BetterResults.com
