Insurance and referrals
Does the VA cover pelvic floor physical therapy in Hawaii?
Yes. The VA covers pelvic floor physical therapy either at a VA clinic or, when the VA cannot provide it within its access standards, through a community care referral to an outside provider, with no cost to the veteran for authorized care.
The details
What to know
Answered by the practice of Dr. Elana Shalem, DPT, pelvic floor and orthopedic physical therapist.
VA Pacific Islands Health Care System serves veterans across Hawaii, Guam, American Samoa, and the Northern Mariana Islands from the Spark M. Matsunaga VA Medical Center in Honolulu and community clinics on the neighbor islands. Pelvic floor physical therapy is a specialty service with limited capacity in that system. When a VA provider places a consult and the VA cannot offer an appointment within its wait-time standard (28 days for specialty care) or drive-time standard (60 minutes for specialty care), the veteran is eligible for community care.
Community care in Hawaii is administered by TriWest under the VA Community Care Network. The veteran's VA provider places the consult, the facility's community care office confirms eligibility, and the referral is sent to a network provider. Visits delivered under that authorization are paid by the VA.
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.
Veterans who are also military retirees, or who have TRICARE through a spouse, can use TRICARE West instead; EMS Therapy is in-network, and TRICARE Select needs no referral to start.
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 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.