Will Insurance Cover Treatment for Chronic Pain?

If you’ve recently started to experience chronic pain, you may be wondering how you’re going to pay for the process of visiting doctors until you discover the cause of your condition, not to mention trying myriad therapies and pharmaceuticals in an attempt to regain control over your life and continue living as normally as possible in the meantime. After all, you have to keep working if you want to pay your medical bills and hang on to your insurance. But the bigger question for most people is what, exactly, does insurance cover when it comes to chronic pain? You don’t want to have to go into every doctor appointment sweating over how much you’re going to have to cover because you’re insurance doesn’t make the grade. However, there are a few ways you can make the process easier and get as much as possible covered by your provider. Here are some tips to help you get started.

The first step, of course, is to find out how your policy measures up, and this means talking to an agent from your insurance provider. The type of policy you pay for could definitely make a difference in what will be covered, so you need to make sure you understand your particular policy, including your expected co-pay and annual deductible, as well as how much of certain treatments and medications will be covered after you’ve paid your up-front portion. You also need to know if you have an HMO or PPO and what that means in terms of the doctors and specialists you are allowed to visit. You may have to work within an approved network of physicians in order to receive full or even partial coverage. Or you might have to visit certain area hospitals. By calling your provider you can get all of the information you need up front to get started making appointments and purchasing prescribed pharmaceuticals.

As the process goes on, don’t forget that you can check in with your insurance provider at any time. In fact, it’s important that you do so in order to make sure that the treatments your doctors recommend will be covered. If your insurance won’t pay for certain treatment plans, you need to find out if they will cover alternative therapies. Your physician or specialist should be able to give you some options, after which you shouldn’t hesitate to call your insurance provide to see which therapies they will cover and what percentage you can expect to pay. And don’t forget to ask if there are upper limits. Some insurers (or policies) have limits on payout for certain conditions or treatments and you need to know what they are so you can plan accordingly and choose treatment plans appropriately.

Now, there are other options. If you are diagnosed with a disability as a result of your chronic pain, you may qualify for Medicare, but this still doesn’t guarantee coverage. And with changes to the healthcare system in the works, you could get caught in the crossfire with “public” options, so you’ll definitely want to speak to someone who can help you to understand what the Patient Protection and Affordable Care Act could mean for your coverage and treatment options. Considering that you may have a long road ahead of you when it comes to visiting doctors, specialists, and pain management facilities like PMIR, you want to understand your options when it comes to insurance coverage so that you can find a plan that will pay for the care you need. It may entail some research on your part, but the outcome will be the peace of mind that comes from knowing you’ll get the coverage you need to treat your chronic pain condition.