cardiac rehab - insurance copayment

[Rivet]

My health insurance requires a copayment for each cardiac rehab session. For 3 visits a week and a $15 copayment, this adds up to $45 per week or $180 per month. Not going to break the bank, but not a great deal either.

Is this the norm now?

[Praline]

I pay $20.00 per session so $60.00 a week for Cardiac rehab. I agree with you..not the best deal.

[Janea]

I am fighting with my insurance company trying to get rehab. My copays are also $15.oo. It will cost me around $250.00 for the entire thing. I wasn't too happy about this either but was then told if I were paying out of pocket it would be $2300.00 So, I feel like it is a good deal and if I am stronger and more confident in my body, well worth it! Now, if only I can get my insurance to pay for the other $2,050.00!

P.S. are you guys finding rehab to be helpful?

[PamO]

My husband's fell under our physical therapy benefit which was a straight dollar benefit, no co-pays each time.

Something to look into: Check to see if your policy as an out of pocket maximum or breakpoint. Co-pays usually don't apply to this, but if you're on a 90/10 plan, check to see if you're reached your maximum. Insurance companies frequently "forget" you've reached the maximum out of pocket and continue to pay out at the 90%.

Example: My plan has a $15,000 breakpoint - this means that our company only has to pay $15,000 per employee per year and over that the insurance company pays (we're self-funded). On the employee end, their out of pocket per year maximum is 10% of the breakpoint = $1,500. So, if you satisfy your deductible ($500 for our plan), you then pay 10% of all costs (except co-pays) up to $1,500. The plan then turns into a 100% paid plan. When you have surgery, you hit that in the first day!