Insurance and referrals
Does HMSA QUEST (Hawaii Medicaid) cover pelvic floor physical therapy?
Yes. HMSA QUEST covers medically necessary physical therapy, including pelvic floor physical therapy, usually with little or no cost to the member. EMS Therapy is in-network with HMSA QUEST and sees QUEST members anywhere in Hawaii by video.
The details
What to know
Answered by the practice of Dr. Elana Shalem, DPT, pelvic floor and orthopedic physical therapist.
QUEST plans may require a referral from the member's primary care provider and may limit the number of visits; both are checked before the first visit. Telehealth visits are covered when the provider is in-network and licensed in Hawaii.
For QUEST members on the neighbor islands, where there is often no local pelvic floor physical therapist and flying to Oahu is not realistic, video visits are frequently the only practical access to this care.
EMS Therapy verifies QUEST coverage before scheduling. Phone 808-330-7934.
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
Common follow-up questions
What does pelvic floor therapy cost with HMSA QUEST?
Usually nothing. QUEST members typically have no copay for medically necessary physical therapy. EMS Therapy confirms coverage with HMSA QUEST before scheduling.
Do I need a referral with HMSA QUEST?
Often yes. QUEST may require a referral from the member's primary care provider, and for longer care an approval from the plan. EMS Therapy checks both before the first visit and tells the member exactly what to ask the doctor for.
Does HMSA QUEST cover pelvic floor therapy by video?
Yes. Telehealth physical therapy is covered when the provider is in-network with HMSA QUEST and licensed in Hawaii. Visits are from home, with no drive and no flight to Oahu.
I am on QUEST on a neighbor island. Can I be seen?
Yes. EMS Therapy sees HMSA QUEST members on Maui, Kauai, Molokai, Lanai and Hawaii Island by video, usually within a week.
Which QUEST plans does EMS Therapy take?
HMSA QUEST. Members of other QUEST plans can call 808-330-7934 to check; coverage for other plans is confirmed case by case.
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.