My doctor gave me a referral for physical therapy but the insurance schedule of benefits excludes "Rehabilitative therapies". Does it mean the insurance doesn’t cover physical therapy?
I am in Boston MA. 29 yr-old Male. No pre existing condition. But I dislocated my shoulder so now it may be a pain to me forever.
I wasn't qualified for masshealth because I missed the application time period when I arrived in Boston. I had my should joint dislocated weeks ago and it still hurts, so I visited a doctor. My doctor gave me a referral for a 2-month physical therapy but the insurance schedule of benefits excludes "Rehabilitative therapies".
It's an individual plan and I paid $339 for the insurance each month. Until today I found it only covers some vaccines (for babies), and some adult health exams. And some extra programs that I can get discount on prescription drugs.
As a matter of fact, I never took 1 single pill of prescription drugs in my life. The funny thing is I am limited to 2 specialist visits/year. If I want to take drugs, where can I get prescription without visiting a doctor? LMMMMMAAOOOOO
If I can't get treatment, why should I have my body checked? What should I do with my body check result, feeling desperate?
I am completely NEW to health insurance in MA and I feel so fooled. And I feel so desperate now with a shoulder that hurts. I don't know if I am going to get stuck in this miserable situation forever but I can't really see any hope.
I'll list a small part of its exclusion:
Any other medical service, treatment, or procedure not covered under this Plan. (means everything maybe? It doesn't mention any specific treatment to any sickness in the schedule of benefits, just some preventative stuff. So it basically mean "screw you" to me.)
Claims for disability resulting from reversal of sterilization
Claims for the completion of forms, or failure to keep scheduled appointments
Recreational or diversional therapy
Supportive devices of the foot
Treatments for sexual dysfunction
Aquatic or massage therapy
Biofeedback training
Skilled nursing facilities
Durable medical equipment and prosthetics
Hospice care, private duty nursing, or long-term care
Residential facility – for charges from a residential halfway house or home, or any facility which is not a health care institution licensed for the primary purpose of treatment of an illness or injury
Claims for temporomandibular joint syndrome
Claims for biotech or specialty prescriptions
Any claim which is not explicitly covered in the schedule of benefits
Genetic testing unless explicitly covered in the schedule of benefits
Organ transplants
Claims for cosmetic surgery, not related to mastectomy reconstruction to produce a symmetrical appearance or prosthesis, or physical complications which result from such procedures.
Chiropractic care
Radiation and chemotherapy
Dialysis
Acupuncture
Alternative medicine/homeopathy
Children dental and vision
Neonatal intensive care (NICU)
Rehabilitative therapies
PCP surgery
And many more!!!!!!!!!!!!! I don't know if I am allowed to write its name down here. And I wonder if it's just what health insurance normally is.
submitted by /u/colinchen010
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