Veterans · Hawaii
Pelvic floor physical therapy for veterans in Hawaii, by video.
TRICARE West in-network; VA community care referrals accepted on approval of our Community Care Network contract. One-on-one video visits with a Doctor of Physical Therapy, from home on Oahu, Maui, Kauai, Molokai, Lanai or Hawaii Island. Women and men.
- TRICARE West in-network
- VA community care: contract pending
- Usually seen within a week
How it gets paid for
Three ways a veteran in Hawaii can be covered.
Which one applies depends on how you are enrolled. Bring your card to the discovery call and we sort it out before the first visit.
1. VA community care referral
The VA pays for care outside its clinics through the Community Care Network, run in Hawaii by TriWest. EMS Therapy's TriWest VA Community Care Network contract request was submitted in October 2026 and is under review. Once it is active, a VA community care referral for pelvic floor physical therapy covers your visits in full. Until then, veterans who also hold TRICARE are covered today, and anyone can start privately with a superbill.
2. TRICARE (retirees, families, TRICARE for Life)
Military retirees and their family members keep TRICARE after service. EMS Therapy is in-network with TRICARE West for Hawaii. TRICARE Select needs no referral to start physical therapy; TRICARE Prime needs a referral from your primary care manager. TRICARE for Life pays after Medicare.
3. Other insurance or private pay
HMSA and HMSA QUEST are in-network. Any other plan is private pay with a superbill you can submit for reimbursement; HSA and FSA cards are accepted.
Step by step
How to ask the VA for a community care referral.
The VA sends care outside its own clinics when it cannot provide a service within its wait-time or drive-time standards, when the service is not offered at your VA, or when it is in your best medical interest. Pelvic floor physical therapy is a specialty service with limited capacity in the Pacific Islands, so community care referrals for it are common. Here is the sequence that works:
1. Tell your VA primary care provider what is going on. Leaking urine, urgency, pelvic pain, pain with intimacy, bowel problems, prolapse symptoms, pain after prostate surgery, or pelvic pain tied to a service injury are all reasons for a pelvic floor physical therapy consult. Use the words "pelvic floor physical therapy" so the right consult is placed.
2. Ask for the consult to go to community care. Say that you would like to be seen by video within a week and that you understand VA Pacific Islands may not have a pelvic floor physical therapist available within the access standard. You can name EMS Therapy and Dr. Elana Shalem as your preferred provider.
3. The VA community care office reviews eligibility and sends the referral. Approved referrals are routed through TriWest to a network provider. Ask the community care office to note EMS Therapy as your preference so the referral comes to us as soon as our contract is active.
4. We call you to schedule. The first visit is a 60-minute video evaluation; follow-ups are 45 minutes, usually every one to two weeks. Nothing is billed to you for care the VA authorized.
If you are not sure whether you are eligible, call VA Pacific Islands at 808-433-0600 (toll-free 800-214-1306) and ask for community care, or call us and we will walk you through it. The Women Veterans Call Center, 855-829-6636, can also help women veterans find services.
What we treat
Conditions common after service.
Pelvic floor problems are common in veterans of both sexes. Years of load carriage, jumping, heavy lifting, childbirth, surgery, and chronic stress all affect the pelvic floor.
Urinary incontinence
Leaking with coughing, running, lifting, or on the way to the bathroom.
Overactive bladder, urgency and frequency
Urgency, frequency, and getting up at night.
Chronic pelvic pain
Pelvic, tailbone, or hip pain that has not responded to rest or medication.
Leaking after prostate surgery
Leaking after prostate surgery; pelvic floor training before and after.
Chronic pelvic pain syndrome
Chronic pelvic pain syndrome and prostatitis-type pain in men.
Painful intercourse
Pain with intimacy, including after childbirth, surgery, or trauma.
Constipation and bowel dysfunction
Constipation, straining, and bowel leakage.
Pelvic organ prolapse
Heaviness or bulge symptoms; non-surgical management.
Low back pain
Back pain that travels with pelvic floor symptoms; load-carriage and lifting injuries.
Hip pain
Hip and groin pain from running, rucking, and jumping.
Why video works
Private, from home, on any island.
Most of pelvic floor physical therapy is education, breathing and pressure management, movement retraining, and a home program. All of it works on camera. For veterans who live far from Honolulu, who cannot take a day off for a clinic visit, or who prefer privacy about these symptoms, a video visit removes the main reasons people put this off.
An internal examination is not possible by video. If a hands-on assessment would change the plan, Dr. Shalem says so and helps coordinate it. Visits are HIPAA-compliant, one-on-one, with nobody else on the call.
Questions
Questions veterans ask
- Does the VA cover pelvic floor physical therapy in Hawaii?
- Can veterans get pelvic floor physical therapy by telehealth in Hawaii?
- Does TRICARE for Life cover pelvic floor physical therapy?
- Does TRICARE cover pelvic floor physical therapy?
- Do I need a referral for physical therapy in Hawaii?
- Do men need pelvic floor physical therapy?
How it works
How a virtual visit works
Most of pelvic floor physical therapy is education, breathing and pressure management, movement retraining, and a home program. All of it works on camera. During the evaluation, Dr. Shalem guides a self-assessment so she can see how the pelvic floor is coordinating with breath and movement. An internal examination is not possible by video; if a hands-on assessment would change the plan, she says so and helps the patient find local care.
Discovery call
15 minutes, free, by phoneA short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.
Evaluation
60 minutes, by videoDr. Shalem takes a full history, watches how you move and breathe, and guides the self-assessments she needs to build a plan.
Your plan
Same visitYou leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.
Follow-ups
45 minutes, every 1 to 2 weeksProgress checks, program updates, and techniques you can do yourself, for as long as they are useful.
For a video visit you will need
- A phone, tablet, or laptop with a camera
- A private room
- A mat or towel
- About an hour
Questions
Before you book
Does the VA pay for pelvic floor physical therapy outside the VA?
Yes, through a community care referral when the VA cannot provide the service within its access standards. Ask your VA primary care provider for a pelvic floor physical therapy consult and request community care.
Can I use TRICARE as a retiree?
Yes. EMS Therapy is in-network with TRICARE West. TRICARE Select needs no referral; TRICARE Prime needs one from your primary care manager; TRICARE for Life pays after Medicare.
Do you see men?
Yes. Leaking after prostate surgery, chronic pelvic pain syndrome, urgency, and pelvic-floor-related erectile dysfunction are all treated.
Which islands?
All of them. Visits are by video, so Oahu, Maui, Kauai, Molokai, Lanai, and Hawaii Island are served the same way.
Is this related to a service-connected condition?
It can be. Pelvic floor symptoms after load carriage, parachuting, blast injury, childbirth during service, or military sexual trauma are seen regularly. Your VA provider decides the consult; we provide the care.
Your physical therapist
Dr. Elana Shalem, DPT
Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed in Hawaii.
Dr. Shalem treats pelvic health for women and men, from pregnancy and postpartum recovery to bladder, bowel, and pelvic pain conditions and recovery after prostate or pelvic surgery, and general orthopedic conditions of the back, neck, hips, knees, shoulders, and feet. Visits are one-on-one and unhurried, and she explains what she is seeing in plain language.
More about Dr. ShalemPrefer to write? Send a message.
Questions about insurance, pricing, or whether physical therapy is the right next step? We reply within one business day.
Start with a free 15-minute call.
Tell us what is going on, hear how Dr. Shalem would approach it, and decide from there.