TheRef

I've been having some issues with my Achilles tendon and Plantar fasciitis that is throwing my body out of whack. I've been going to PT on and off for the last year and while My Doctor doesn't believe is caused by the bike itself she believes it sure isn't helping my case. She suggested I look into my shoe and cleats and overall position on the bike. (and off the bike for that matter.)

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.

CliffordK

Are there any podiatrists that specialize in sports cycling?

1nterceptor

Bike fitters aren't medical professionals; highly doubt insurance will pay.
When I had trouble/pain in my knee; I got a Dr. recommendation from the
local cycling club. Sports doc I went to was also a cyclist:

What's up Doc by 1nterceptor, on Flickr

RushFan2112

There is a 0% chance that it would be covered under any health insurance plan.

sund

You have to find a PT that does bike fits. I've gotten 3 done at different PTs and I just had to pay the co-pay.

TheRef

How did you find this pt?

RNAV

surgeonstone

0.00 to be exact. Like in Zip, Nada, Nyet, no, nine, nowayjose,righhhhhhttttt, surrrre, unnhuh, nope,,not gonna do it, are you like, nuts,

sund

There are a couple of ways. Look for PTs in your area that specialize in sports. Check out their website and see if they do bike fits.

For example: Bike Fitting | Peak Sports and Spine Physical Therapy

You can also look for a specialist through a bike fitting certification place like BikeFit.

Find a BikeFit Pro - Bikefit

RushFan2112

Unless there's an ICD-10 code with a medically accepted treatment of "bike fitting" and it's performed by a licensed medical professional AND specifically called out as a covered service on the plan SPD, no insurance plan in America will recognize it as a covered expense. The plan would likely cover the treatment/therapy related to the injury (e.g. soft tissue disorder). The PT is potentially billing the service as something else, but that would be insurance fraud and punishable by fines, loss of medical license and possibly jail time.

sund

The original poster is treating an injury. Anyway, that was my experience treating some injuries of my own.

CliffordK

The OP apparently has a real medical condition being treated by doctors and PT.

But, Unfortunately we live in a society where it may be easier to get a doctor to prescribe thousands of dollars worth of pills and surgeries rather than prescribing going out and riding one's bike for a few hours a day.

As a rider without an official "fit", I'm not convinced that someone in the back of a bike shop can move the seat and bars around to make a huge difference.

On the other hand, shoes, shoe inserts, cleat position, wedges, and angles could potentially do wonders for foot problems. There are even semi-custom and fully custom cycling shoes (at a significant cost).

Getting someone else to pay? That is the rub. And your local physician and PT experts should be able to help you with real medical referrals. Do you have an HSA account? At least a few years ago, regulations on HSA accounts were much more lax than regular insurance policies.

Of course, if you were a PRO, then you'd get all your cycling related health care provided for you.

Anyway, getting insurance to pay for an unlicensed technician in the back of a bike shop to do a "fit" is unlikely, even if they are the best in the business. On the other hand, a licensed PT or Podietrist may be able to serve your needs.

Or, perhaps just bite the bullet and pay out of pocket.

TimothyH

Why wasn't bike fitting part of ObamaCare?

Does Canada pay for bike fits? Just thinking out loud.

uscdigital

i just filed a claim for a new saddle.

seattlebuzz

Sorry, this is just wrong. I've had a bike fit done by a bike fitter (i.e., not a medical professional) that was absolutely covered by insurance with no shenanigans. Granted, I have an excellent plan through my wife's work and no doubt it's rare for this to be covered, but OP should at least check. Some companies have seen the light and figured out that it's in their best interest to encourage healthy habits for their insureds.

Dave Cutter

If you like your LBS... you can keep your LBS. I would assume the same applies for bicycle fitters.

I have always been told that: If we announce our needs and wave a checkbook in the air... someone will present themselves with something to fill that need.

That doesn't guarantee satisfaction with what will be provided.

I think the exact same wisdom would apply to an insurance card.

RushFan2112

Dude - I'm not trying to pick a fight so I'll leave it at this, but there's no way a bike fitting is covered under a health insurance plan. I can tell you with certainty that this is true regardless of plan type, funding arrangement and/or state mandate for any state. The only thing you can possibly be describing is an executive MERP, but that isn't health insurance, it's a reimbursement plan subject to annual maximums. It could also be through an employer's wellness program, but it would be unusual to cover a bike fitting (though technically it's possible), but like the MERP it isn't insurance.

Even if the insurance company wanted to cover it they couldn't on a fully insured plan due to state filing restrictions. On a self funded basis there wouldn't be any system support to adjudicate the claim nor would there be any controls in place.

That all said, a bike fitting is a worthy investment and something I encourage all riders to do.

seattlebuzz

Ok, if you say so. The company was openly advertising it as an insurance benefit, not part of a wellness program, and we submitted the claim and were reimbursed through the health plan administrator, so I'm not sure what to tell you. Frankly, unless you're an attorney who's done a 50-state survey on this particular issue, I'm skeptical of your certainty here (aside from the fact that I've actually done it).

In any case, agreed that there's no point getting into it. Hopefully OP can get it covered one way or the other and everybody will live happily ever after.

HazeT

Mine was... went to PCP and asked him to refer me to the sports medicine department. Got my bike fit done 100% covered.

Inpd

I have nothing to contribute apart to say its funny hownsome people say it can never ever be done and the others say they did it and the former group then say they didnt!

tarwheel 

Perhaps related. I wear orthotics in my shoes, and without them I have serious foot problems that make it hard to walk. Over the years, my insurance plans have varied depending on jobs. Some insurance plans covered the cost of orthotics, others did not. Depends on the plan. However, it always struck me as absurd that an insurance plan would not cover orthotics, without which my ability to walk was severely limited, which in turn could lead to all sorts of health related issues due to lack of exercise.

Nachoman

Would you reconsider now to maybe a 0.0001 % chance?

valygrl

I had a fit covered a few years ago. I went to Boulder Center for Sports Medicine, which was (then) a part of Boulder Community Hospital. I was being treated for a knee problem, was referred by the physician's assistant that I saw, and it was covered. The appointment was called a "Medical Bike Fit." I think it was Anthem insurance.

69chevy

Why is medical insurance so expensive? People using it for things they don't medically "need" is one reason.

indyfabz

****