Using Out-of-Network Benefits for Physical Therapy

Using out-of-network insurance benefits used to be unheard of, however, in light of the increasing trend of paying more money (think higher premiums, deductibles, copays, coinsurance)- it is becoming a more popular choice with people who are looking for value-based care.

Out-of-Network vs In-Network

Out-of-network providers chose to have relationships and contracts with patients instead of insurance companies.  This means that the provider is able to treat what they need to, when they need to, and how they need to, based off the individual patient’s specific needs be they physical, mental, or financial.

In-network providers have a contract with an insurance company. Note- the insurance company does not hand-pick the “BEST” providers to be in their network.  Providers need to apply to be in-network, but the application has nothing to do with skill level, experience or merit.  Also- many insurance companies have closed enrollment to new providers, meaning that new grads or experienced PTs from out of state cannot be become in-network providers, limiting potentially new knowledge and skill bases and limiting the subscribers pool of potential practitioners.