At 12:51 PM 1/7/2001 -0500, you Linda Wagner    wrote:
>Bob,
>
>How are you getting insurance to let you go to continuous PT?

Mainly because we have a good insurance plan - & my employer (a local govt
entity) is self insured.   The Kaiser-type plans (& most others we've been
offered) would only cover "rehabilitative" therapy - & then for a very
limited number of visits.   But one plan, an ppo HMO, covers my
"habilitative" PT for 60 visits/year; even with a $20/visit co-pay & about
that much more "coinsurance", it's still a big help.     Between illness,
bad weather, & not being able to get away from work, I only get in about
65-70 visits a year.   And we have a pre-tax medical expense withholding, a
"cafeteria plan" that let's me withhold enough in pre-tax dollars from my
salary to cover my share.

I understand that once I hit Medicare, there'll be no PT coverage.

I was getting manually stretched (hip flexors, quads, hamstrings, & back),
but after the last 20 years of that it seemed like my hip joints & my
therapist were starting to wear & hurt.  So a couple of years ago my PT
switched me to myofascial release.


>I would
>love to be manually stretched and practice gait training/balance
>year-round once or twice a week but my PT can't "justify" my being there
>that much once I plateau...So, as you said, you go for awhile, then a
>year or two later you go back...but you always plateau at a slightly
>lower point than the last time!

That was one of the points I made a few years ago when  a insurance
administrator denied coverage because it was not rehabilitative
therapy;   I appealed it, & since they were sensitive to ADA issues I tried
to raise the shadow of the ADA (but not naming it) by using such phrases as
"do not think this is an unreasonable accommodation".   But I really think
the fact that my employer is self-insured, and that I'm a supervisor &
known to many of the top brass probably helped more than logic.


>  I'll take any hints you have.
>
>Linda


Good luck.
BOB