Unfortunately, insurance isn’t always the easiest thing to understand. Plans have unique features which vary by the type of insurance coverage. Things like deductibles, copays, coinsurance, out-of-pocket maximums, and in-network or out-of-network providers are factors that affect rehab insurance coverage. Understanding how each insurance feature works will help you understand what the cost of rehab will be for you or your loved one. 

Deductibles, copays, and coinsurance are all out-of-pocket costs that you, the policyholder, agree to when you sign up for health insurance coverage. Along with a monthly premium payment, the above costs are set in each policy for the different kinds of medical care available. Coverage for these services also varies by state, so it’s important to check with your plan to understand what is covered.

When looking at insurance plans that cover rehab, you’ll probably come across the terms PPO and HMO. They are two common health insurance coverage plans with some key differences to consider. HMO, or health maintenance organization, limits medical care to an in-network group of doctors, facilities, and treatments. However, this generally makes the cost of rehab lower as the options are fewer. Most HMO plans will not cover out-of-network medical care. PPO, or preferred provider organization, offers a wider range of coverage for out-of-network care, but the premium and out-of-pocket costs are generally higher.