Many people need to see a physical therapist sometime in their lives. For example, for pain, recovery after surgery or for a chronic condition. But what about the cost of these treatments? This article answers frequently asked questions about physical therapist insurance.
Is physical therapy included in basic insurance?
Physical therapy is often not covered by basic insurance. This means you need supplementary health insurance to get your treatment reimbursed.
For people with a condition on the government's list of chronic disorders, physical therapy treatments are reimbursed from the 21st treatment under the basic insurance. You then pay for the first 20 treatments per disorder yourself. You can possibly take out supplementary insurance to also receive reimbursement for the first 20 treatments. The excess applies to the reimbursement of physiotherapy from the Basic health Insurance.
Up to 18 years of age
Children up to 18 years of age receive a maximum of 18 physiotherapy treatments per complaint from the basic insurance. The screening, intake and examination together count as one treatment. You consult with the therapist on how many treatments are necessary
Physiotherapy, exercise and skin therapy are covered by the same type of care. Per day, the insurer will reimburse a maximum of one treatment of the same type of care. If you need more treatments, you can take out supplementary insurance for this. There is no excess for the basic insurance for children up to 18 years of age.
When is it useful to take out supplemental insurance for physical therapy?
Whether you need supplementary health insurance for physical therapy depends on your current care needs and the risk you run of a condition. If you are healthy and do not engage in high-risk sports, then - as far as physical therapy is concerned - you may not need any supplementary insurance at all, or the cheapest supplementary package will suffice.
If you have a higher risk of injury because of the sport you practice, supplementary insurance for physical therapy is worth considering. And if you suffer (more often) from your back or have weak joints, it may be wise to take out a slightly more expensive supplementary insurance.
Always ask yourself if you want to pay for physical therapy yourself if something happens, or if you prefer to pay a (monthly) premium for it.
What does physical therapy cost?
The question of how much physical therapy treatment costs is difficult to answer. There are no set prices for physical therapy. So the price for a regular treatment varies by provider, but count on about €45 per treatment. A specialist fee, for example for manual therapy or pediatric physiotherapy, is usually a bit more expensive. If you have supplementary insurance for physical therapy, the costs will be fully or partially reimbursed by your insurer.
Most insurers have contracts with physical therapists. Check the insurer's website to see if the physical therapist of your choice has a contract with your insurer. If that is not the case, you will often not be reimbursed for the full amount.
Note: If you receive reimbursement for physical therapy under the basic insurance, this will be deducted from your deductible. This does not apply if the treatment is reimbursed from a supplementary health insurance.
Is there a difference in the reimbursement of treatment at a contracted and a non-contracted physiotherapist?
In many cases there is. Most health insurers reimburse 100% of the treatment at a contracted therapist. This reimbursement is often limited to a maximum number of treatments or a maximum amount, depending on the care package you choose.
The reimbursement for a non-contracted therapist is often limited. For example, you will be reimbursed 75% of the treatment or a maximum amount per treatment.
Useful to know
- Physical therapy is usually not covered by basic insurance
- Check with your health insurance company if they have a contract with the physiotherapist you want to visit. If this is not the case, the health insurance company cannot reimburse your costs (in full).
- In all cases, it's wise to check with your health insurer to see what is covered, what you can take out additionally and how many treatments you expect.
The benefits of group health insurance
- Take advantage of broader benefits than with individual insurance.
- Health insurance is there for you, your partner and children.
- We arrange your switch. Make a choice and we'll do the rest!
