Insurance and referrals
Does TRICARE cover pelvic floor physical therapy?
Yes. TRICARE covers pelvic floor physical therapy when it is medically necessary. TRICARE Select members can see a network physical therapist with no referral; TRICARE Prime members need a referral from their primary care manager. EMS Therapy is in-network with TRICARE West and sees military families in Hawaii by video.
The details
What to know
Answered by the practice of Dr. Elana Shalem, DPT, pelvic floor and orthopedic physical therapist.
Pelvic floor physical therapy is billed under TRICARE's physical therapy benefit. For Select, the cost share is the standard network outpatient cost share, which for most active-duty families is low or zero; for Prime, there is no cost share for active-duty family members with a valid referral. Retirees and their families have modest cost shares under both.
Military treatment facilities in Hawaii have pelvic floor capacity only at Tripler, with waits; the branch clinics at Pearl Harbor, Kaneohe Bay, and Hickam treat active-duty members only for physical therapy, so spouses and dependents are routed to the network. A telehealth network provider is seen from home with no drive across the island.
EMS Therapy verifies TRICARE eligibility before the first visit and, for Prime members, explains exactly what to ask the PCM for. 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
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.