Physical, occupational, and speech therapy is covered on all plans
As you age, you may develop different needs around your physical and cognitive health. Community Health Plan of Washington (CHPW) covers physical, occupational, and speech therapy for all our Medicare Advantage plan members.
This benefit includes:
- Coverage for up to 12 visits per calendar year for each type of outpatient therapy: up to 12 physical therapy visits, up to 12 occupational therapy visits, and up to 12 speech therapy visits.
- After the initial 12 visits, prior authorization is required for further treatment.
- Evaluation and reevaluation do not count toward your 12 visits.
(All CHPW Medicare Advantage plans also cover inpatient physical, speech, and occupational therapies. Please see your individual plan’s Evidence of Coverage for details.)
Depending on your plan, you may have a copay or coinsurance. Please see specific plan information below.
Physical, occupational, and speech therapy benefits by plan
| 2021 | 2020 | |
|---|---|---|
| MA Plan 1 (HMO) 016 | $40 copay | 20% coinsurance |
| MA Plan 2 (HMO) 010 | $30 copay | 20% coinsurance |
| MA Plan 3 (HMO) 008 | $30 copay | $30 copay |
| MA Plan 4 (HMO) 009 | $30 copay | $30 copay |
| MA No RX Plan (HMO) 006 | $30 copay | $30 copay |
| MA Dual Plan (HMO SNP) 014 | $0 to 20% coinsurance | $0 copay |
Did you know that certain prescription medicines are available as a 90-day supply? Medicine that you take on a long-term basis to manage your health is called a “maintenance drug.” A 90-day supply makes it easier to keep taking the medicine you need to feel your best. You may also be eligible to receive your long-term medications through free home delivery.
