If you are considering to go through an osteopathic treatment in Utah, it is important to know where you will be covered under Medicare, the government-funded universal health system, or your private health insurance.
A patient with a chronic illness, for example, a long-standing musculoskeletal illness, who is headed by a family physician, may be eligible for a Medicare reimbursement for up to five osteopathy sessions in a calendar year, as expected by an osteopath registered with the board of osteopathy in Utah. There are, however, some conditions that apply for a patient to be eligible for the discount.
First, being treated by an osteopath should be recommended by a physician who has provided MBS chronic disease management services for the patient and patient support arrangements. A reference GP is required to use a reference form provided by the Department of Health and Aging, and this form must be submitted to the first session of osteopathy. Once the five sessions have been done, if you need more treatment, you need a new reference GP.
Secondly, if more than five osteopathy sessions are held, subsequent sessions are not covered by the Medicare reimbursement.
Thirdly, the osteopath is required to provide a written report to the GP, usually at the end of the sessions, detailing the treatment provided, the tests or evaluations carried out, and the plans for the future management of the patient’s condition.
A patient who has private health insurance, but does not choose to claim that osteopathy insurance, instead choosing to claim Medicare reimbursement, is also eligible to request the cost of five treatment sessions in a calendar year, provided that the conditions are met.
As osteopaths in Utah health professionals, a patient to whom osteopathic treatment is covered by the private health insurance system does not require a referral from a family physician to conduct a session. In general, a private health insurance will offer either a form of guarantee or extras, the patient’s right to a certain number of osteopathic treatment sessions during a calendar year, depending on the level of coverage or make a contribution to the costs of osteopathy sessions up to an agreed amount.
However, it is important for patients to consult with their private health insurance that osteopathy is covered in their particular plan, and what other expenses they may be responsible for. It is also important to know that patients who have chosen not to assume the cost of their osteopathic treatment in their private health insurance, and instead have chosen to claim their Utah Medicare reimbursement, cannot use their private health insurance to cover any deficit between Medicare reimbursements and fees paid for osteopathy.