Insurance and referrals
Does Aetna cover pelvic floor physical therapy?
Yes. Aetna plans cover physical therapy, including pelvic floor physical therapy, when it is medically necessary, subject to the plan's copay or coinsurance, deductible, and visit limits. EMS Therapy is an in-network, designated (Tier 1) Aetna provider in Florida and sees Aetna members anywhere in the state by video and in-home in Miami-Dade.
The details
What to know
Answered by the practice of Dr. Elana Shalem, DPT, pelvic floor and orthopedic physical therapist.
On Aetna tiered plans such as Choice POS II, a designated provider means the lower copay tier for the member. Most Aetna PPO and POS plans do not require a referral for physical therapy; Aetna HMO plans do. Visit limits per year are common and are confirmed during benefit verification.
Telehealth physical therapy is covered by Aetna when the provider is in-network and licensed in the patient's state.
EMS Therapy verifies Aetna benefits before the first visit. Florida phone 786-273-9151.
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
Your physical therapist
Dr. Elana Shalem, DPT
Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed in Florida.
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.