Insurance and referrals
Does TRICARE for Life cover pelvic floor physical therapy?
Yes. TRICARE for Life covers medically necessary physical therapy, including pelvic floor physical therapy, as secondary coverage after Medicare Part B for military retirees age 65 and over.
The details
What to know
Answered by the practice of Dr. Elana Shalem, DPT, pelvic floor and orthopedic physical therapist.
TRICARE for Life is the wraparound coverage for retirees and their spouses who have Medicare Part A and B. Medicare pays first; TRICARE for Life pays the remaining cost share for TRICARE-covered services, so most beneficiaries have no out-of-pocket cost for physical therapy. No referral is required.
Pelvic floor physical therapy for urinary incontinence, prolapse symptoms, post-prostatectomy leaking, and chronic pelvic pain is a covered service when medically necessary. The provider must accept Medicare assignment for TRICARE for Life to pay as secondary; EMS Therapy's Medicare enrollment for Hawaii is in process, and retirees under 65 with TRICARE Select or Prime are in-network with TRICARE West today.
Call 808-330-7934 with your coverage and we confirm the benefit before the first visit.
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.