The pelvic floor is a common problem for people with uteruses. A pelvic floor problem occurs in up to 24 percent of genetically female individuals during their lifetime. A wide range of costs are associated with pelvic floor treatment, from a few hundred to several thousand dollars, and most insurance companies cover these costs.
Pelvic floor physical therapy is an effective and least invasive treatment option for a wide variety of pelvic floor issues. You are likely to have heard about pelvic floor therapy if you have seen a doctor or researched treatments for urinary and fecal incontinence, pregnancy and postpartum problems, pelvic pain, constipation, frequent urination, or pain during sexual activity.
How does this therapy work, and is it usually covered by insurance? The following information will tell you what your insurance covers about pelvic floor therapy.
What Is Pelvic Floor Therapy?
Treatments like this can improve quality of life and restore normal functioning by resolving problems like incontinence, pain, and discomfort. Pelvic floor issues are evaluated and treated by physical therapists who have received specialized training.
The pelvic floor comprises muscles that support your reproductive and urinary tracts and control your bladder and bowel function. You may also experience pelvic floor dysfunction elsewhere in your body due to the attachment of the pelvic floor muscles to the tailbone and pubic bone.
Is Pelvic Floor Therapy Covered By Insurance?
Insurance carriers widely cover pelvic floor therapy because it can reduce or prevent many common medical conditions and prevent expensive surgery. The important thing to remember is that each plan is different.
Therefore, patients must check with their insurance provider to determine if the treatment is covered or inquire about the types of insurance accepted and how much they will be responsible for out of pocket. Your deductible may apply to some costs, even if the service is covered.
If your policy covers pelvic floor physical therapy, you should know that not all physical therapists are covered, just like doctors and other specialists. Additionally, some pelvic floor physical therapists work in cash-only clinics that do not accept insurance, although they may provide an invoice for those wishing to seek reimbursement from their insurance. The best way to avoid surprises when paying for treatment is to clarify this upfront.
What Is Involved In Pelvic Physical Therapy?
An evaluation of your medical records and a discussion of your current symptoms and goals will occur at your first appointment with a pelvic physical therapist. Your doctor will ask you about any medical conditions that motivated your visit, your childbirth history, as well as any pain you are experiencing during urination or bowel movements, intercourse, or other bodily functions.
The physical examination will include a visual examination of your posture and functional abilities, with special attention paid to your pelvis, spine, and hips. You may also be assessed based on how you breathe.
There are times when your doctor may need to perform an internal exam, such as a vaginal or rectal exam, to test your pelvic floor strength, find tender points, or address scar tissue. Patients can skip this exam if they feel uncomfortable doing so. Still, you should know that doing so enables your therapist to design the most effective treatment plan for a faster recovery.
A pelvic floor physical therapist may use the following techniques when treating pelvic pain.
Exercises and Movements
The exercises your physical therapist suggests will target and strengthen the muscles in your pelvic floor that need strengthening. Diaphragmatic breathing and certain poses, toe taps, heel slides, and other movements may be used.
The Kegel exercise is popular for strengthening the pelvic floor muscles by relaxing and contracting them. Physical therapists can help you perform these exercises correctly to get the most benefit from them and heal faster. This is great for controlling incontinence and relieving pain during intercourse.
This technique may reduce muscle spasms and pelvic pain. You may receive special equipment and instructions on using it at home, or your physical therapist may perform it in their office.
Trigger Point Therapy
Trigger point therapy involves applying pressure to specific points in the body, known as trigger points, to promote healing.
What Are the Benefits of Working with a Pelvic Floor Physical Therapist?
An experienced pelvic floor physical therapist is knowledgeable about pelvic floor disorders and how to treat them. The following can be done:
- Diagnose your pelvic floor issues accurately. The pelvic floor muscles can become weak during pregnancy and childbirth, while they can also become too tight during pregnancy and childbirth. A pelvic floor physical therapist will also assess your core muscles for tightness and tenderness that may be causing pain or other symptoms, as well as any weakness in the pelvic floor.
- Ensure that you are performing Kegels correctly. Physical therapists are trained in pelvic floor exercises and can ensure you engage the appropriate muscles.
- Give tips on how to exercise or treat different pelvic floor issues. A weak pelvic floor muscle, for example, can result in incontinence issues and pelvic organ prolapse, while a non-relaxing pelvic floor is more commonly associated with pelvic pain, back and hip pain, painful sex, and difficulty going to the bathroom (though it can also result in incontinence). A physical therapist can develop a treatment plan individualized to your symptoms.
Also, Read: Pet Insurance Companies With No Waiting Period
When Do You Need Pelvic Floor Therapy?
A pelvic floor therapist is knowledgeable about the symptoms and treatment of pelvic floor muscle pain related to low to high-tone forms of pelvic floor dysfunction.
However, it is important to note that pelvic floor muscle dysfunction isn’t always the cause of pain in the pelvic region. Several symptoms may indicate a more serious condition:
- The sensation of burning during urination
- Menstrual bleeding during heavy periods
- Severe menstrual cramps
- A period of irregularity
- Stool or urine containing blood
- An abnormal discharge from the vaginal canal
- Vomiting and nausea
- The fever
When experiencing any of these symptoms, talk to your doctor or gynecologist immediately. You may have a gastrointestinal infection, urinary infection, or reproductive infection that requires further medical attention.
What Typically Happens During a Pelvic Floor Physical Therapy Session?
An initial pelvic floor physical therapy session typically involves a thorough subjective history, an external examination, and an internal examination.
The Internal Exam
There are a few differences between your internal exam and your annual examination with your OB. For example, stirrups or a speculum are not usually used.
- You will be asked to undress, change into a dressing gown, and lie on an exam table as your therapist works with you.
- Your pelvic floor muscles and other connective tissues and nerves will be assessed by inserting a gloved finger into your vagina.
- The therapist may instruct you to contract and relax your pelvic floor during the internal examination. You may also be asked about your pain level; some tissues may be palpated. The purpose of this is to identify tender spots.
The External Exam
Your therapist will likely check you for the following during the external exam:
- Separation of the abdominal muscles (diastasis recti)
- The hernia
- The abdominal muscles may also be affected by other issues.
Besides your spine, hips, pelvis, and sacroiliac joint, your doctor will probably also examine your spine, hips, and pelvis.
Your Treatment Plan
Then, your PT will formulate a treatment plan incorporating exercises and manual techniques to strengthen, relax, and coordinate your muscle movements more effectively. The exercises will be performed during your therapy session, and you will likely receive a home exercise routine between sessions.
There are other tools your therapist may use, such as electrostimulation and biofeedback. All of these tools can assist you in identifying and improving your ability to contract and relax your pelvic floor optimally.
So Why Would Someone Consider Going to a Pelvic Physical Therapist Who Doesn’t Take Insurance?
Get Better Sooner
Your pelvic physical therapist can help you get better by getting you seen faster, letting your body dictate the type of care it needs (not the insurance company), and paying more attention to you.
Getting Seen Faster is Easier
You need help as soon as possible when you are on maternity leave before you return to work. A lot of people need to be seen as soon as possible if they are in pain, have had accidents, or are suffering from things like constipation and painful sex. You may have to wait up to three months for an appointment at clinics that accept insurance. There’s no need to wait for pelvic PT at many self-pay practices (including Renew)! Most doctors can see you within a week, if not sooner.
You will Receive More Individual Attention
Patients can often spend more time with providers in self-pay (out-of-network) practices. It is common for clinics that accept insurance to have less time to spend with each patient or multiple patients simultaneously.
Insurance Carriers Don’t Dictate Your Treatment
Most pelvic physical therapy conditions are not considered “medically necessary” by insurance carriers. The presence of ailments like painful sex and vaginismus significantly affects the quality of life but is sometimes denied treatment. A pelvic physical therapist may be unable to reimburse patients for preventative services during pregnancy or before the onset of symptoms. No matter how your insurance carrier covers treatment, you can get the treatment you need from an out-of-network provider.
The Cost Will be Clear From the Beginning
Our pelvic physical therapists at Renew Pelvic Health and many other out-of-network providers include all services they provide in your visit at the flat rate you pay when you schedule your appointment. Biofeedback and dry needling are examples of these treatments, as are manual techniques such as myofascial release and joint mobilizations, as well as exercises, stretching, and patient education. Everything is included. There are no surprises after the fact!
Does Insurance cover Pelvic Floor Physical Therapy?
Pelvic floor physical therapy coverage depends on your insurance company’s policies and your physical therapist’s practices. Your sessions can also be paid for with funds from a flexible spending account or health savings account.
Are Pelvic Floor Problems Only Seen In People With A Uterus?
No. The pelvic floor muscles are an important part of sexual function in genetically male individuals. A person with erectile dysfunction or problems ejaculating may not be able to function correctly if these muscles do not function properly. Physical therapy is an effective treatment for pelvic floor dysfunction in these individuals. Although it can easily be mistaken for a prostate gland infection called prostatitis, it is important to see a doctor first to make sure you get the right diagnosis.
Does Insurance Cover Pelvic Floor Physical Therapy?
Pelvic floor physical therapy is usually covered by insurance. There are differences in insurance plans, and some pelvic floor physical therapists are only in network with some insurance companies. If you want to confirm whether your pelvic physical therapist will accept your insurance or the out-of-pocket cost of the treatment, you can contact your insurance carrier.
Some physical therapists in out-of-network clinics do not accept insurance or cash pay. You can independently seek reimbursement from your insurance carrier by requesting an invoice from these physical therapists. There is a wide range of prices for cash payment practices.
How are Pelvic Floor Disorders Treated?
It is important to determine your condition before choosing a treatment. Injections and nerve stimulation are just a few of our treatment options. Kegel exercises and physical therapy are simple, nonsurgical approaches that can be done at home. If the condition is more serious, surgery may be required to correct or repair it.
Will I Need Surgery to Fix Pelvic Floor Dysfunction?
Your condition will determine how severe it is. An urogynecologist might recommend a procedure for prolapse prevention or incontinence support. Some procedures can be performed vaginally without the need for external incisions.