Do Physical Therapists Contract with Medicare Supplemental Plans

Do Physical Therapists Contract with Medicare Supplemental Plans for Payment?

Medicare supplemental policies are also called MediGap Policies. These policies may only be sold to Medicare beneficiaries and do not require physical therapists to contract with them individually for payment.

If a physical therapist or occupational therapist is a contracted Medicare Part B provider the supplemental plan will pay based on the policies guidelines.

Are All Secondary Policies Supplemental Plans?

No! When Medicare Part B is the primary insurance policy, Medicare beneficiaries have the right to purchase a supplemental (MediGap) policy or non-supplemental policy as a secondary.

“All supplemental policies are secondary policies, but not all secondary policies are supplemental policies.” – Tony Maritato, PT

What is the difference between a Medicare Supplemental Policy, MediGap Policy, and Non-Supplemental Policy?

There is no difference between a Medicare supplemental policy and a Medigap policy. They are the same policy by different names.

The real difference to understand is the difference between a supplemental policy and non-supplemental policy in the secondary position.

What is a non-supplemental policy?

A non-supplemental policy is a regular, stand along insurance policy. Supplemental policies can only be sold to individuals who have Medicare Part B as their primary insurance.

An example of a patient with Medicare Part B primary and a non-supplemental secondary policy would be as follows:

A patient has Medicare Part B as primary insurance and his spouse has coverage under an employer supplied insurance plan. The spouse’s policy fuctions as the patients secondary insurance.

In the case of a non-supplemental secondary, the treating physical therapist may be required to contract with that specific insurance company. 

Watch this video to understand the difference between a supplemental vs non-supplemental secondary insurance policy.