Use this dismissible announcement area to promote sales and important site-wide messages.

Insurance & Billing

Pelex Sports is committed to helping all of our patients minimize financial burden, especially young athletes. 

Depending on your insurance plan, many patients will pay as little as $50 (which is FSA/HSA eligible).

Our #1 goal is to provide elite care for female athletes to prevent future injuries while minimizing their out of pocket obligations. Pelex is dedicated to making healthcare accessible and affordable; if you do not have out of network benefits, or cost is a barrier, we have a responsive care team that will work with you to explore generous payment options and self-pay discounts.

Right now, Pelex Sports does not participate with private insurance plans, but don’t confuse this with “Pelex doesn’t take my insurance.” What this means is that our fees are covered under your “out of network” benefits, which may be at a lower level of coverage. When you see a provider who is not contracted with your insurance they can do something called “balance billing.” This is when a provider sends a patient a bill for the balance (or portion of the balance) between what the insurance company paid for your visit and what the provider billed (which sounds very scary!!) However, one of the benefits to seeing an out of network provider is that because they are not contractually obligated, they can adjust this balance bill at their discretion.

So what does this even mean?!

Prior to your visit with Pelex Sports, we will have you pay $50.
Pelex will submit all Pelex Sports visits directly to your insurance company for payment. Depending on your benefits, your insurance company will either apply a certain amount to your insurance deductible and co-insurance or (if your deductible has been met) they will pay for a portion of the visit.
If your deductible has not been met, we will send you a bill for the balance between that $50 and what the insurance company “allowed” (i.e. the most a healthcare plan is willing to pay for a certain service or procedure) for the visit.
If your insurance company paid for the visit, we will accept that as payment in full and adjust your balance accordingly.

FYI ALL BCBS MEMBERS: Since we are not contracted with BCBS, you may receive a check in the mail for our services. When this happens, our team will reach out to you and collect that check amount. 

What about testing and other diagnostic procedures?

All diagnostic testing will be done at imaging and lab facilities near you that participate with your health plan. 

There are several home testing kits that can be delivered to your door that are HSA/FSA eligible.