Does Physical Therapy Fall Under VHIS or Accident Insurance Coverage? OneEssential Explains Everything You Need to Know!
Can VHIS Cover Physical Therapy?
VHIS generally only covers physical therapy expenses incurred during hospitalization. If a patient undergoes physical therapy while admitted to a hospital, the costs will typically be reimbursed. Additionally, pre-hospitalization and post-hospitalization physical therapy, as well as therapy before or after surgery, are usually covered under VHIS. However, the exact coverage details and reimbursement limits vary, so it’s best to check with your insurance provider.
In summary, VHIS mainly covers hospitalization-related treatments and medical services. If your injury does not require hospitalization, the physical therapy expenses will likely not be covered under VHIS.
Is Physical Therapy Covered? Check Out These Examples
Case 1: Covered Under VHIS
Mr. Lee fractured his right leg in a car accident and required hospitalization for surgery. During his hospital stay, the doctor assessed his condition and recommended physical therapy to help restore his leg function and mobility. As a result, Mr. Lee received physical therapy arranged by the hospital during his hospitalization.
Explanation:
Since Mr. Lee received physical therapy while hospitalized and it was directly related to his surgery, the associated costs fall within the coverage of VHIS.
Case 2: Not Covered Under VHIS
Ms. Chan strained her lower back while working out and visited a private clinic for treatment. The doctor diagnosed her with a muscle strain and recommended physical therapy. She then underwent multiple physical therapy sessions in an outpatient setting to relieve pain and restore mobility.
Explanation:
Since Ms. Chan’s physical therapy was not a result of hospitalization or surgery, the costs are not covered under VHIS.
Can Accident Insurance Cover Physical Therapy?
Accident insurance is generally more flexible than VHIS and typically covers physical therapy costs, even if they are not related to hospitalization or surgery. However, some policies may have limits on the number of therapy sessions or a daily reimbursement cap. The total coverage for physical therapy usually ranges from $6,000 to $20,000. Additionally, accident insurance often includes an annual medical expense limit, which covers all treatment costs combined, so it’s important to check this when making a claim.
How to Claim Physical Therapy Insurance
First, visit a doctor for an outpatient consultation and obtain a referral letter.
Undergo physical therapy and pay for the treatment upfront.
Collect receipts and proof of treatment from the physiotherapy clinic.
Fill out the insurance claim form provided by your insurer.
Submit the completed claim form along with the required documents.
Wait for the insurance company to review and process your claim.
Things to Consider When Claiming Physical Therapy Insurance
1. Qualifications of the Physiotherapist
To be eligible for a claim, the insured must receive treatment from a registered physiotherapist. Treatments from chiropractors, Chinese bone-setting (跌打), or massage therapy (推拿) are generally not covered.
2. Claim Limit on Number of Sessions
Physical therapy may require just 1-2 sessions or extend to monthly follow-ups. Most VHIS and accident insurance policies have a maximum claimable number of sessions, meaning long-term physiotherapy costs may not be fully covered.
3. Doctor's Referral Letter Required
To claim physical therapy expenses, you must provide a doctor’s referral letter, diagnosis report, and medical report. These documents must be submitted with a claim form completed by a registered doctor.
4. Exclusions to Coverage
Some activities or circumstances are not covered by insurance, including: High-risk sports like skiing, diving, skydiving, or professional sports. Injuries caused by self-harm, preventive treatment, or substance abuse (excessive drugs/alcohol consumption)
Always check your policy details to understand the specific coverage and exclusions before making a claim.
Is OneEssential’s Physiotherapy Service Recognized by Insurance?
Yes, OneEssential has multiple registered physiotherapists who can provide official receipts and medical reports for insurance claims. This makes OneEssential’s physiotherapy services recognized by insurance providers.
Insurance-Compatible Physiotherapy Services
OneEssential’s professional physiotherapy center offers treatments for various conditions, including knee pain, wrist pain, and more. With extensive experience treating Hong Kong’s elite athletes, our services are eligible for insurance claims.
However, we strongly recommend checking with your insurance provider to confirm whether physiotherapy is covered under your specific policy.