Does Medicare Cover Physical Therapy?

Yes, Medicare covers physical therapy when it is medically necessary and prescribed by a doctor or other healthcare provider. If you are recovering from an injury, surgery, or managing a chronic condition, Medicare Part B helps pay for outpatient physical therapy services.

However, how you access that coverage and what you pay out of pocket depends entirely on which Medicare path you choose: Traditional Medicare (often paired with a Medigap plan) or Medicare Advantage.

The simple truth is that Medigap vs. Medicare Advantage is a rigged comparison. The real choice is Traditional Medicare (Parts A and B) versus Medicare Advantage (Part C). The supplement decision comes after you choose the Traditional path - it is a component of that path, not an alternative to Advantage.

If you choose Traditional Medicare, Part B covers 80% of the Medicare-approved amount for physical therapy services after you meet your annual Part B deductible. There is no longer a hard cap on how much Medicare will pay for physical therapy in a year, provided your provider confirms the services remain medically necessary. You can see any physical therapist in the country who accepts Medicare, giving you the freedom to choose the best care for your recovery.

If you add a Medicare Supplement (Medigap) plan to your Traditional Medicare coverage, that plan steps in to pay the remaining 20% coinsurance. This means that once your Part B deductible is met, your physical therapy sessions could cost you nothing out of pocket. We believe in straight answers, no surprises. When you are focused on getting your mobility back, the last thing you need is a stack of bills.

On the other hand, if you choose a Medicare Advantage plan, your physical therapy coverage is managed by a private insurance company. While these plans must cover everything Traditional Medicare covers, they set their own rules for how you get that care. You will typically pay a copay for each physical therapy session. More importantly, you will likely be restricted to a network of approved physical therapists, and your plan may require prior authorization before you can even begin treatment.

Protect what you've earned by understanding these differences before you need care. Traditional Medicare puts you and your doctor in charge of your physical therapy schedule. Medicare Advantage puts an insurance company between you and your therapist.

Whether you are rehabbing a knee replacement or managing arthritis, you need to know your coverage will be there. We are built by people like you, and we are on your side of the table. We will walk you through every option so you can make the right call for your health and your wallet.