Does Health Insurance Cover Physiotherapy in India?

What is Physiotherapy?

Physiotherapy is a physical treatment used to restore and maintain body movement and function in case of an injury, illness or disability. It helps people recover through physical rehabilitation, health & fitness and preventing injury/illness. Physiotherapy not only treats existing injury/illness but also helps to reduce the risk of another injury or illness in the future.

Physiotherapy combines treatments through sound waves, electrical currents, lasers, vibrations, etc., with physical exercises to treat different health issues. Thus, physiotherapy focuses on holistic treatment by directly involving the patients in their own recovery.

When is Physiotherapy Required?

Generally, physiotherapy is used to treat the following health problems:

• Joints, Bones and Soft Tissues – This includes treatment for sports injuries, back pain, shoulder pain, neck pain, etc.
• Heart and Circulation – This includes patient's rehabilitation after a heart attack.
• Brain or Nervous System – This includes restoring movement issues due to a stroke, Parkinson's disease, multiple sclerosis, etc.
• Lungs and Breathing – This includes treatment for Chronic Obstructive Pulmonary Disease (COPD), cystic fibrosis, etc.

Is Physiotherapy Covered by Health Insurance?

Yes.

Physiotherapy is covered by several health insurance plans under OPD cover. They pay for the cost of physiotherapy taken on an Outpatient Department (OPD) basis but up to a specific limit. However, some health insurance plans also cover physiotherapy expenses under post-hospitalization expenses in case the insurer has accepted an in-patient hospitalization claim.

All mediclaim insurance policies cover the cost of physiotherapy after an initial waiting period of 30 days. Some plans may also have a specific waiting period for OPD cover of up to 2 years. Besides, if the patient needs physiotherapy for a pre-existing disease (PED), they will first have to serve the PED waiting period of up to 3 years before claiming the expenses.

Therefore, patients are advised to go through their policy terms and conditions carefully to understand the exact coverage for physiotherapy and its waiting period.

People Also Read: OPD vs IPD: Know the Difference Between OPD and IPD Treatments

What is Not Covered by Health Insurance for Physiotherapy?

Health insurance plans for physiotherapy do not cover the following:

• Preventive physiotherapy
• Physiotherapies at home
• Alternative therapies like chiropractic services or acupuncture
• External aids and devices
• Health supplements

Why Should You Buy Health Insurance for Physiotherapy?

Here are a few reasons why buying health insurance for physiotherapy is a good idea:

• Financial Support – Physiotherapy is an expensive treatment as it continues for a long time. For instance, a single physiotherapy session in Delhi can cost somewhere between ₹200 to ₹2000, depending on the type of therapy used. Medical insurance motivates patients to keep coming for these sessions unless they recover without any financial burden.
• Timely Rehabilitation – Physiotherapy is an integral part of recovering from certain surgeries, injuries and illnesses. For instance, patients require physiotherapy after undergoing a knee replacement surgery to resume mobility. With health insurance coverage for physiotherapies, patients can start their rehabilitation process on time without worrying about paying the medical bills.
• Holistic Care – Physiotherapy not only focuses on pain rehabilitation of the patient but also fitness and health. For instance, physiotherapy for lower back pain involves ultrasound therapy and IFT treatment followed by back exercises. By covering physiotherapy expenses, medical insurance plans ensure holistic care of the patient.
• Cashless Treatments – With health insurance, patients can avail physiotherapy sessions on a cashless basis at a network provider of the insurance company.

How to Choose the Best Health Insurance Plan for Physiotherapy?

Follow the tips given below to choose the best health insurance policy for physiotherapy:

1. Check for Physiotherapy Coverage

   Choose a health plan that explicitly mentions covering physiotherapy either on an OPD basis or under post-hospitalization expenses. Some plans may also offer OPD coverage as an add-on cover available on paying an extra premium.

2. Prefer Plans with No Sub-limits

   Some mediclaim insurance plans may have sub-limits for OPD cover. Go through the policy terms and conditions carefully to know if any sub-limit applies to OPD cover. Make sure to opt for a health policy with no sub-limits or that comes with a sufficient amount to cover the cost of multiple physiotherapy sessions.

3. Go For Affordable Plans

   Health insurance plans with OPD cover can be a little expensive. Make sure to compare different health plans online to find an affordable policy within the budget that covers the cost of physiotherapy.

4. Go for the Lower Waiting Period

   Although post-hospitalization expenses will be covered after the initial 30-day waiting period, OPD cover may have a higher waiting period. Go through the policy document carefully to know the waiting period applicable to physiotherapy expenses. Preferably, choose a plan with no separate waiting period for OPD coverage.