Insurance Plans Accepted for Foot & Ankle Care

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Health insurance can be confusing, especially when every plan has different benefits, deductibles, co-pays, co-insurance rules, referral requirements, and coverage limits. At Foot & Ankle Specialists in West Jordan, we want patients to have helpful information before their visit so they can better understand how insurance may apply to podiatry care, foot and ankle treatment, procedures, products, and follow-up visits.

Not all insurance plans provide the same benefits. A service, procedure, brace, orthotic, or product may be covered by one insurance plan and excluded by another. Because your health insurance policy is a contract between you and your insurance company, we recommend contacting your insurance provider directly to confirm your specific benefits, network status, deductible, co-pay, co-insurance, and any referral or authorization requirements before your appointment.

Insurance Plans Accepted at Foot & Ankle Specialists

Foot & Ankle Specialists accepts most insurance plans for podiatry care in West Jordan. Our office provides care for many common foot and ankle concerns, including heel pain, plantar fasciitis, bunions, ingrown toenails, toenail fungus, diabetic foot care, wounds, ankle injuries, sports injuries, custom orthotics, and surgical consultations when needed.

The insurance information below is provided to help patients understand the types of plans we commonly work with. Insurance participation can change, and individual benefits may vary, so patients should always verify coverage with their insurance company before receiving care.

Types of Health Insurance Plans

PPO Plans

PPO stands for Preferred Provider Organization. A PPO plan usually has contracts with physicians and medical providers that the insurance company would prefer patients to see. These providers are considered “in network.” Providers outside that group are usually considered “out of network.”

With a PPO plan, the deductible, co-pay, and co-insurance may be different depending on whether you see an in-network or out-of-network provider. However, PPO plans often give patients more flexibility and may still offer some benefits when a patient chooses to see an out-of-network doctor. Patients should contact their insurance company to understand how their specific PPO benefits apply to podiatry visits, procedures, orthotics, imaging, or surgery.

HMO Plans

HMO stands for Health Maintenance Organization. An HMO plan is usually a closed network of health care providers. In most cases, there are no benefits for seeing an out-of-network doctor unless the visit has been specifically approved or authorized by the insurance company.

If you have an HMO plan, it is important to confirm whether Foot & Ankle Specialists is in network before your visit. You may also need a referral or authorization from your primary care provider depending on the rules of your plan.

Basic Insurance Terms Patients Should Know

Understanding common insurance terms can help you better prepare for your visit and avoid confusion about financial responsibility. Below are several terms patients often see when reviewing podiatry benefits.

Co-pay

A co-pay is a payment made by the patient at the time a service or product is provided. The amount is determined by your insurance plan and may be required for office visits. There can be exceptions after certain procedures. Some minor procedures may carry a 10-day global period in which co-pays are not required, while other surgical procedures may have a 90-day global period.

Deductible

A deductible is the amount you must pay before your insurance begins paying its portion of the fees. Deductibles vary by insurance plan and may apply differently to office visits, procedures, imaging, orthotics, products, or surgery.

Co-insurance

Co-insurance is the percentage of coverage your insurance will pay after your deductible has been met. For example, with an 80/20 plan, the insurance company pays 80% of the covered cost while the patient pays 20% after the deductible has been met.

Out-of-Pocket Maximum

An out-of-pocket maximum is the maximum amount of money your insurance plan requires you to pay for covered services during a plan period. After this amount has been met, the insurance company generally pays for covered services and products at 100%. This amount may be calculated by combining your deductible and your portion of co-insurance.

Important Insurance Notice

Health insurance is a form of payment for products and services received in our office. It is important to remember that a health insurance policy is a contract between you and your insurance company. Foot & Ankle Specialists does not set the terms, limitations, exclusions, referrals, authorizations, deductibles, co-pays, co-insurance amounts, or out-of-pocket requirements of your insurance policy.

Consequently, it is important for patients to be informed about their benefits and financial responsibilities according to the terms of their insurance plan. We recommend that you contact your health insurance company to understand your policy before receiving care. If you have questions about our office financial policy, please contact our office for guidance.

In-Network Insurance Plans

Foot & Ankle Specialists accepts many in-network insurance plans. The list below includes insurance plans that have been accepted by the practice. Because insurance participation can change, patients should confirm current coverage with their insurance company before scheduling or receiving treatment.

Out-of-Network Insurance Plans

Some out-of-network insurance plans may still provide benefits depending on your policy. If your insurance plan is out of network, we recommend contacting both your insurance company and our office to better understand possible coverage, charges, and patient responsibility.

• PCN (Primary Care Network)
• Select Health
  • Select: Advantage
  • Select: Med
  • Select: Med + (We are out of network with this plan, but it may offer out-of-network benefits. Contact our office and we can work with you and the insurance on the charges)
  • Select: Value

Insurance and Podiatry Services

Insurance coverage may vary depending on the type of podiatry service being provided. Office visits, diabetic foot care, wound care, surgical consultations, X-rays, custom orthotics, braces, injections, procedures, and foot or ankle surgery may each be handled differently by your insurance plan.

For example, some plans may cover an office visit but require separate rules for orthotics or durable medical equipment. Other plans may require referrals, pre-authorization, or proof of medical necessity before certain treatments are covered. Because every plan is different, confirming your benefits before care can help you better understand what may or may not be covered.

What Patients Should Confirm With Their Insurance Company

Before your appointment, you may want to contact your insurance company and ask about your podiatry benefits. This can help you understand your plan and avoid surprises related to coverage or patient responsibility.