By Dagmar Growe, LMT

LMTs will likely see an increase in Uniform Medical insured patients looking for a United Healthcare provider. Premiums for Regence Uniform plans for retired members for 2023 have increased significantly so people are looking for cheaper options, one of which is United Healthcare. Please note that

• United Healthcare is separate from Regence. This means you have to apply to them to be a provider. It also means you should not expect that their reimbursement rate is the same.

• Some United Healthcare Uniform plans do not cover massage therapy. Uniform Medical is a self-insured plan. It is a trust fund for health care expenses financed by the State of Washington for its employees, rather than coverage bought from an insurance company. However, Uniform hires insurance companies to administer the trust fund. These plans are regulated by ERISA (Employee Retirement Income Security Act of 1974, a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans). Because federal law supersedes state law, Washington’s every-category-of-provider provision does not apply to these plans. They may opt to provide massage therapy benefits or not, and they can apply additional rules which are not always clear. We know of at least one plan that offers benefits for acupuncture and chiropractic care but not for massage therapy.

• Some plans may offer the option of out-of-network benefits, allowing you to bill even if you are not a provider. This usually offers better pay because you have not agreed to the company’s rates. You can also offer to provide the client with a billing statement or receipt so they can apply for reimbursement if the plan allows.

• Remember HSAs (Healthcare Savings Accounts) and FSAs (Flexible Spending Accounts) . You can offer to accept payment through those if you are set up to accept credit cards. Make sure you are registered as a healthcare provider with your payment processor. 

As always, if you choose not to be a provider, educate the client about your reasons. I have found that most patients are appalled when I tell them what the insurance companies would pay me and how much work would be involved.