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What the Numbers Say | Insurance: Finding the Best Fit



Is ASTYM® right for you? 

When Michael Westphale, PTA, first saw ASTYM® used on patients and witnessed 

firsthand the amazing results, he knew he wanted to learn the technique. He has not been disappointed. 

Michael Westphale, PTA 

ASTYM® is a tooled manual therapy that works to both regenerate healthy tissue and reduce or eliminate scar tissue. An evidence-based treatment technique, ASTYM® does wonders for chronic muscle tightness and repeated muscle strains, tendonitis, plantar 

What the Numbers Say About Low Back Pain 

You’ve had lower back pain for two weeks, so finally you decide that enough is enough and make an appointment with your doctor. Your doctor’s decision about what to do next can have a big impact on how quickly your back pain 

resolves. Research has shown 

that some courses 

of action work better 

than others. 

Believe it or not, 

some decisions lead 

to higher costs and 

poorer outcomes: 

Delayed Treatment: The subjects were 32,070 patients with a low back pain diagnosis from their primary care physicians. Those who received therapy within 14 days of their initial doctor visit had fewer follow up visits, a lower incidence of advanced imaging, fewer injections, fewer surgeries, and decreased use of opioid medications compared with those who delayed the initiation of physical therapy.1 

MRI: With patients who saw their primary care doctor for a new low back pain problem, those who went directly to PT spent, on average, $1871. People who had an MRI first spent an average of $6,664 in the year following their initial complaint to their doctors. Don’t get me wrong – there is a place for MRI and CT scans, but it’s not the first thing to go to for low back pain.2 

Why? Why would just having advanced imaging make your pain harder to treat?

fasciitis, IT Band Syndrome and 


Join Michael on 

Thurs Nov.19th at 5:30 pm 

at ALTA 

Restore, Revitalize & Recover with ASTYM® 

RSVP: by November 16th 

IS there really an 

advantage to 

Advantage Plans? 

Many seniors sign up for Advantage plans only to realize that they have drastically limited access to their favorite providers, and there’s no going back until they change plans in the next calendar year. 

Insurance: Finding the Best Fit 

With the vast array of health insurance plans available, choosing one to fit your needs can be daunting. However, there are some questions that you can ask yourself to choose the plan that will best fit your needs. 

First, how do you normally access health care? Think about medications you take on a regular basis, medical conditions that need ongoing care or treatment and planned medical events in the next 12 months. Consider any event coming up in the next year that is not a normal event, such as a pregnancy or elective surgery. Then assess how each plan will provide for each of those situations, and what it will cost you out of pocket to manage them. 

Next, are you willing to spend 

more in premium dollars to 

reduce your maximum out of 

pocket expense should an 

unplanned medical event 

occur? What is more 

important to you concerning 

your healthcare coverage: 

lower premium costs or lower 

out of pocket costs when you utilize medical services? 

Here’s an additional consideration: will an HMO work for you? Remember using an HMO plan limits your hospital and physician choices to In Network providers. This is a list of providers contracted with the insurance company. If your provider is not on that list, your insurance will not cover you there. This is a big consideration if choosing your provider is important to you. 

Healthcare reform has brought significant changes to the structure of the health plan designs. All health plans must cover a wide variety of preventative care services at 100%

At first glance it seems like the easier choice because you can avoid the hassle of buying a secondary insurance. The catch is that Advantage plans can have a limited provider list, like any other PPO or HMO. Before you sign up, make sure your favorite providers are on the list for your particular advantage plan. 

If you have questions, contact Alena at 303-444-8707, 

ext. 103. 

Have a Safe and 

Happy Halloween! 

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paid by the insurance carrier. All Out of Pocket expenses accumulate to the health plan Maximum Out of Pocket Limit. These expenses include: 



Office visit copays 

Prescription copays 

The Maximum Out of Pocket Limit plays a larger role in choosing a health plan. If your usual health care expenses are low, then perhaps a larger deductible, lower premium health plan will fulfill your needs. If your usual health care expenses are high and you frequently meet your annual deductible, then with the Maximum Out of Pocket limit perhaps a lower deductible, higher premium health plan will fulfill your needs. 

As we said, choosing a health insurance is more daunting than ever. Questions are inevitable and we know just the person to answer them. Jim Marsh and his team at Hofgard Benefits can help you. Visit their website at


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