Seattle Forrest

So far four people in this thread have done the impossible, and we're still on page one!

EDIT: This post makes it two pages.

Mr IGH

I have Obamacare, anything out of network isn't covered (unless it's a certified emergency) and my deductible is $6500 before they pay a dime. While I haven't checked, I'm ready to bet a month's premium ($480) that Kaiser isn't giving me a free bike fit....

mpath

Here's a thought - how about just paying for a professional bike fit?

TheRef

Here is another thought... if you don't have anything to add to a constructive conversation stay out of it!

TheRef

To clarify, my issue is not so much paying for the fit myself. My biggest problem is finding a medical professional who understands my issues and guiding me through the process.
Most fitters I consulted said that they could work with me but most have limited understanding of my injuries and pain and refer back me to the doctors. The doctors prescribed injections. lots of pt which gets very expensive and it gets better. Then after a while it flares up again and I'm back to where I began.

mpath

What a load of c**p....Your thread title "How to get your health insurance to pay for a bike fitting session."

"I remember reading here about how some people had their health insurance pay for a bike fitting. I've done some quick research but came with nothing. Is that a myth or there is a chance to get this paid by insurance? Let me know if you have any experience dealing with this."

And now you're saying, "To clarify, my issue is not so much paying for the fit myself...."

Dan333SP

Health Insurance Reimbursement - Excel Physical Therapy | Specialized Orthopedic and Sports Rehabilitation ? Serving Bozeman and Manahattan, Montana

"David Coletta, physical therapist and co-owner of Excel Physical Therapy of Bozeman and Manhattan, recently completed the BikeFit Clinical Level 2 advanced training in Seattle, Washington. His instruction included upper level road bike fitting and tri-bike/time trial bike fitting. David provides bike fitting services out of the Bozeman location and offers both health insurance billing and cash pay options."

Bike fit FAQ - Corpore Sano Physical Therapy

From the above link-


Will my insurance cover a bike fit?

In general, most insurance will cover this service as long as we are dealing with an injury or pain syndrome related to the specific activity. Insurance does not recognize bike fit as a service; they recognize pain or injury related to the need for Physical Therapy services (which is why physical therapy is the category the treatment falls under).
You will need to check with your insurance company to see if Corpore Sano (Erik Moen or Kari Studley) is a contracted, in-network provider on your plan. Although insurance coverage is not necessary to see us, it gives you the best payment option and the least out of pocket expense to you.
A referral, prescription or pre-authorization for physical therapy may or may not be needed. You may also have a co-pay, which we would collected when you come in to the clinic. Your insurance provider will be able to tell you if you need any of these in order for physical therapy benefits to be paid.
If you are requesting a bike fit only for “performance,” your insurance would not see that as appropriate. If this were the case, the cost would be $225.00 for a one-hour appointment.


Anyway, I feel bad contributing useful information when there's such a fun
"No way!" "Yes way!" fight going on here.

TheRef

Thanks a lot Dan, this post was very helpful.

Dan333SP

Thanks! There's a first time for everything

Seattle Forrest

These guys are fantastic by the way.

02Giant 

I was thinking the same and sure enough, there it is.

Doug28450

It only took you 4635 posts.

PepeM

Yeah folks, you don't need to be able to ride without pain. Man it up!

Dan333SP

We've established that some private health insurance carriers in some circumstances WILL pay for a bike fitting.

Whether they SHOULD be paying for it, from a cost perspective, is an interesting question. It's easy to say, "This isn't necessary treatment!!! No way should this get lumped into the group cost for my carrier!!"

It's more complex than that. You could argue that someone requesting a bike fitting may only choose to do it if their carrier pays up front, which over the long term would allow them to ride more, have a reduced risk of obesity and cardiac issues, and fewer overuse injuries that require treatment. You can think of it like a wellness incentive program, except paid for by the carrier rather than the company. There is a risk they'd pay for it and the insured would never ride again, but there's also a good chance they'd enjoy riding more and remain healthier for longer, reducing the overall cost. Heck, the cost of a fitting would probably be offset by just one less PCP office visit over the remaining lifespan of that insured cyclist.

Insurance companies aren't stupid and blindly getting fleeced by therapists who are sneaking bills for bike fittings under the radar through their bill review. If they're paying for it, they've done a cost/benefit analysis on whether it's the right choice for that particular plan and patient.

69chevy

You don't need your health insurance to pay for a bike fit that may or may not do anything to help a nagging pain.


It's free to move your cleats toward your heels a little and see if it helps as this article mentions.


Coaches Panel: How to overcome Achilles tendon problems | VeloNews.com

nycphotography

Hey, why not get the internet instructions and just 'scope the knee yourself too.

69chevy

My bad, he should rely on a bike fitters super powers of guessing how to ease the pain.

Dan333SP

People whose services 69Chevy doesn't currently believe in:

Bike fitters
Cycling Coaches
Santa Claus?

indyfabz

Auto mechanics?

69chevy

Maybe insurance will cover a cycling coach?


Then he could follow his coaches orders for a season and then get dropped on a charity ride by guys who don't "train" with a plan.

Seattle Forrest

You don't need a bike, either. So what?

If you're faced with a choice between using a benefit you're entitled to because you paid for it (or received it as compensation) versus paying out of pocket, the smart choice is the first one.

If that bothers you, you should start writing insurance companies and telling them you'd like them to stop paying for this.

Dan333SP

I smell a good story here. Details? New thread?

TheRef

Funny that are people throwing shots at me albeit indirectly just for asking a question. I pay over $12K a year in premiums taken from my pay check for a family of 4 not counting deductibles or co-pays. I'm 38 and overall very healthy. Up to recently I seldom used my insurance.

As for paying out of pocket for a fitting... well I have done so in the past. I don't and didn't mind paying $150 for a session but I've been quoted over $500-600 for the level of fitting I need now which a fitter told me it might take over 4-5 hours including video and motion analysis and a few return visits . Several fitters from LBS's have turned me down saying that what I need is beyond their abilities. In short I need someone with a understanding of my medical condition.

I didn't intend for it to become a political discussion but I've paid over $60k in premium over the years without using and you criticize me for asking other's people's experiences? REALLY? I don't want anything for free. But from what I see it's a win win situation if it can keep me coming back to PT and the doctors.

So really, if you don't have anything positive to add to the conversation stay out of it.
If you want me to man up without knowing the severity of my condition well.. that says more about you than it does about me.

Thanks for the ones willing to share your experiences.

Bassmanbob

I'd love to know what CPT code the physical therapist used to get a bike fitting covered.

RShantz

Completely irrelevant. Surely you realize what you've paid & used in the past has nothing to do with current coverage or premiums. This logic is how people justify "questionable" items.