Does job-based or Marketplace insurance cover physical therapy?

Yes, PT is covered, usually with an annual visit limit. Rehabilitative services are an essential benefit. Plans commonly cap the number of visits a year and may require authorization after an initial set of visits. Cost: Usually a specialist copay per visit or deductible plus coinsurance.

Does Original Medicare cover physical therapy?

Yes, Medicare covers medically necessary PT with no hard annual cap. Once your therapy costs pass a yearly amount, your therapist must confirm that the care is medically necessary. Cost: Generally 20% of the Medicare-approved amount after the Part B deductible.

Does Medicare Advantage cover physical therapy?

Yes, Medicare covers medically necessary PT with no hard annual cap. Once your therapy costs pass a yearly amount, your therapist must confirm that the care is medically necessary. Medicare Advantage plans must cover this too, but set their own copays and often require in-network providers and prior authorization. Cost: Your plan’s copay or coinsurance: check the Evidence of Coverage.

Does Medicaid cover physical therapy?

Covered, with visit limits that vary by state. Children under 21 get medically necessary PT under EPSDT.

Is physical therapy covered by insurance?

Outpatient PT for injuries, surgery recovery, and pain. Here’s how each kind of plan usually handles it.

Ask a specific question Plan a visit: cost and doctors Check it against my plan

Employer or MarketplaceCovered with conditions
Yes, PT is covered, usually with an annual visit limit.
More details
Rehabilitative services are an essential benefit. Plans commonly cap the number of visits a year and may require authorization after an initial set of visits.
Cost: Usually a specialist copay per visit or deductible plus coinsurance.
Original MedicareCovered with conditions
Yes, Medicare covers medically necessary PT with no hard annual cap.
More details
Once your therapy costs pass a yearly amount, your therapist must confirm that the care is medically necessary.
Cost: Generally 20% of the Medicare-approved amount after the Part B deductible.
Medicare AdvantageCovered with conditions
Yes, Medicare covers medically necessary PT with no hard annual cap.
More details
Once your therapy costs pass a yearly amount, your therapist must confirm that the care is medically necessary. plans must cover this too, but set their own copays and often require providers and prior authorization.
Cost: Your plan’s copay or coinsurance: check the Evidence of Coverage.
MedicaidCovered with conditions
Covered, with visit limits that vary by state.
More details
Children under 21 get medically necessary PT under .

Plan type	How it’s usually covered
Employer or MarketplaceCovered with conditions	Yes, PT is covered, usually with an annual visit limit. Rehabilitative services are an essential benefit. Plans commonly cap the number of visits a year and may require authorization after an initial set of visits. Cost: Usually a specialist copay per visit or deductible plus coinsurance.
Original MedicareCovered with conditions	Yes, Medicare covers medically necessary PT with no hard annual cap. Once your therapy costs pass a yearly amount, your therapist must confirm that the care is medically necessary. Cost: Generally 20% of the Medicare-approved amount after the Part B deductible.
Medicare AdvantageCovered with conditions	Yes, Medicare covers medically necessary PT with no hard annual cap. Once your therapy costs pass a yearly amount, your therapist must confirm that the care is medically necessary. plans must cover this too, but set their own copays and often require providers and prior authorization. Cost: Your plan’s copay or coinsurance: check the Evidence of Coverage.
MedicaidCovered with conditions	Covered, with visit limits that vary by state. Children under 21 get medically necessary PT under .

What usually has to be true

Visit limits are common.
A plan of care and documented progress are required.

Good to know

Habilitative therapy (learning new skills) is a separate essential benefit.

Occupational therapy · OT to regain daily-living skills.
Chiropractor · Spinal manipulation and chiropractic care.
Surgery · Inpatient or same-day surgical procedures.

Sources

Typical rules for 2026 plans, checked against these sources on October 20, 2026. Your plan’s own documents decide.

1
What Marketplace plans cover
HealthCare.gov
Marketplace plans cover outpatient care, hospitalization, mental health care, prescription drugs, rehabilitation, laboratory services, preventive services, and other essential benefit categories.
2
Physical therapy
Medicare.gov
Part B covers medically necessary outpatient physical therapy; you pay 20% after the deductible, and there is no hard annual dollar cap, though medical review can apply above a threshold.
3
Compare Original Medicare and Medicare Advantage
Medicare.gov
Medicare Advantage plans cover everything Original Medicare covers (except hospice, which Original Medicare continues to pay), usually use provider networks, often require referrals or prior authorization, and may offer extra benefits such as dental, vision, and hearing.
4
Mandatory and optional Medicaid benefits
Medicaid.gov
States must cover mandatory benefits such as inpatient and outpatient hospital care, physician services, laboratory and X-ray services, home health, and nursing facility care; many other benefits, including adult dental, vision, and prescription drugs coverage details, are state options.
5
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
Medicaid.gov
EPSDT requires Medicaid to cover screening, vision, dental, hearing, and all medically necessary services for children and adolescents under 21, even when the state does not cover the service for adults.

General information about how coverage usually works, not a decision about your plan. Your plan documents and insurer have the final word.

Is physical therapy covered by insurance?

What usually has to be true

Good to know

Related

Sources