Quiet Reflection: When Insurance Influences Healthcare Access
TW: This article includes mention of physical assault.
Hello to all my Rooted in Wellness readers. Today’s blog touches on a topic that many of us—both patients and providers—encounter but rarely discuss openly: the role of insurance in determining the care patients receive. While this post isn’t meant to criticize the entire insurance industry, I do want to reflect on some real-world experiences that highlight how insurance policies can sometimes impact patient care in frustrating and disheartening ways.
To start, I’ll say this: health insurance can offer many benefits. It increases accessibility to care, helps cover the cost of services, and allows people to see providers they might not otherwise be able to afford. I’ve worked in both insurance-based and cash-based physical therapy settings, and I can absolutely appreciate the opportunities insurance can create for patients.
However, I’ve also seen firsthand how insurance plans can limit care. From restrictions on the number of sessions allowed, to delays in approval, to unexpected denials after treatment has already begun—these administrative hurdles can leave patients feeling confused, defeated, or stuck. In some cases, people may not receive the full care they need simply because it wasn’t approved.
One of my goals with Roots Performance & Wellness is to help bridge this gap—offering care that supports people holistically, and helping them better understand the healthcare system they’re navigating. The decision to start my own practice was, in part, inspired by patients whose access to care was limited due to insurance.
I want to share two stories that have stayed with me. These are just a few examples of many, but they illustrate how even motivated, compliant, and in-need patients can struggle to get consistent care.
The first story involves a patient I was working with for pelvic floor physical therapy. She was experiencing symptoms following a traumatic assault, and came to our clinic hoping to heal physically and emotionally. She was open about the challenges she faced—how the ongoing physical symptoms were triggering and made it harder to move forward after her trauma. Despite this, her insurance approved only two visits. Additional visits were denied, even though there was medical documentation and a police report to support the severity of her case. Sadly, this patient wasn’t able to continue care out-of-pocket. As a provider, it was incredibly difficult to watch someone so in need be turned away due to circumstances outside of her control.
Another more recent patient came to me after two years of persistent hip and groin pain. She had seen multiple specialists and undergone various tests, ultimately receiving a diagnosis of a labral tear. She wanted to give physical therapy one last try before considering surgery. After just five sessions, she was already experiencing significant pain relief and was returning to normal daily activities. Yet despite her clear diagnosis, compliance, and documented progress, her insurance denied additional visits. Understandably, she was frustrated—especially after finally finding something that helped.
These cases aren’t shared to vilify insurance providers. Rather, they’re meant to show the reality that many people face in our healthcare system. As a clinician, it’s disheartening when effective care is cut short—not because it’s not working, but because it wasn’t pre-approved or exceeded an arbitrary cap.
In future blog posts, I hope to share more about how patients can advocate for themselves within the healthcare system, explore alternative models of care, and highlight resources that empower people to take ownership of their health journey. No one should have to feel lost, or like their healing is dictated by paperwork.
Let’s keep learning, growing, and finding new ways to support each other. You deserve care that sees you as a whole person. And remember—being healthy looks good on you.
Until next time,
Dr. Rachel Wolinski, PT, DPT, Cert. Dn
Roots Performance & Wellness