Thursday, September 29, 2022

Does Medicare Cover Medical Massage

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Benefits Of Massage Therapy

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Massage therapy can be helpful with many ailments, such as:

  • Lower back pain
  • Cancer pain
  • Muscle pain and injury

Other benefits of massage include relieving stress, helping you to sleep better, and flushing toxins from the body.

Massage can also provide heart benefits, improve circulation, loosen joints, speed up recovery from a sports injury, improve nerve function, and decrease inflammation.

Are Massages Covered By Insurance

With many people turning to massage therapy as a medical treatment, it seems that health insurance should cover massages. However, not all policies do.

For example, Medicare does not cover massage therapy, so you will likely be responsible for 100% of the costs if you seek this treatment. Even if your health insurance provides coverage, there may still be limitations.

The definition of massage therapy may vary, depending on the insurer. That definition of massage, and the reason youre getting one, will likely determine whether insurance will cover it.

If massage treatment isnt covered in your policy, be sure to ask about alternative options. Its also a good idea to discuss them with your doctor.

How To Get A Physician Medical Massage Referral

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The art of massage is, to many, more than a way to relax or de-stress the body. For millions of people suffering from joint or muscle conditions or a range of other illnesses, massage can be an effective type of treatment. One potential problem lies in the setup of many national health systems, where massage is not formally considered an effective medical treatment. Insurance companies often consider massage to be an elective treatment that has no medical necessity. As a result, visits to a massage therapist will often not be covered by medical insurance. One exception is when the patient succeeds in getting a referral from his physician to go to a massage therapist. For those who want to get a physician medical massage referral with the goal of getting massage visits covered by insurance, some critical steps apply.

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Can I Use Insurance To Pay For A Massage Chair

We get asked that question a lot, and the answer is yes and no. If you have already used your deductible and you would like your insurance company to cover the cost of a massage chair, the answer is almost always no. When Worlds Best Massage chairs wrote this, massage chairs do not have an insurance medical code or DME and cannot be covered by insurance. BUT, the question is can you use your FSA or HSA to cover some or all of the costs.

For some of you, the answer is YES! Why only some? Because to get compensation from your insurance company to pay for your massage chair, youll, in all likelihood, need to meet two conditions:

  • You have a chronic back issue, and perhaps a history of claims to treat your condition
  • You have either an HSA or an FSA .

Think you might qualify? If you have had chronic back pain, well leave that to other blog posts to explore this condition certainly, it is one of the reasons people buy a massage chair. But for this article, lets take a look at the HSA and the FSA to understand better how they work and why they may qualify you for a massage chair purchase.

Find Medicare Advantage Plans In Your Area

Does Medicare cover massage therapy? Information and costs

A licensed insurance agent can help you find Medicare Advantage plans in your area. They can help you learn about what services and prescription drugs might be covered by Part C plans where you live.

Compare Medicare Advantage plans in your area

Or call 1-800-557-6059TTY Users: 711 24/7 to speak with a licensed insurance agent.

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Other Types Of Therapy Covered By Medicare

If you were interested in massage therapy as a form of pain management, there are other types of treatments offered by Medicare under some circumstances. This includes medication management, occupational and group therapy.

Medicare Part D, an optional benefit that covers prescription drugs, could also help with pain management by providing more access to medications.

Medicare will also cover physical therapy if it is medically necessary and used to treat an injury or illness, like recovery from an accident or medical emergency.

Part A will cover inpatient physical therapy at a rehabilitation facility, while Part B will cover at-home or outpatient physical therapy. Massage could be part of physical therapy treatment.

Chiropractic care is covered by Medicare if there is a bone in your spine that is out of position. Acupuncture treatments for chronic lower back pain are covered, yet cap at 12 appointments in a 90-day span. You will typically pay 20 percent of the cost for most of these services.

Some Medicare Advantage May Cover Massage Therapy

Medicare Advantage plans are sold by private insurers as an alternative to Original Medicare. While massage therapy is not typically covered by Medicare Advantage plans, some plans may offer it as a benefit.

In 2019, the Centers for Medicare and Medicaid Services wrote a letter to all Medicare Advantage programs that included an encouragement for Medicare Advantage plans to offer therapeutic massage as a benefit in their 2020 plans.1

Every Medicare Advantage plan must provide at least the same hospital and medical benefits as Medicare Part A and Part B, and many Medicare Advantage plans provide additional benefits such as:

Medicare Advantage plan benefits can vary widely from plan to plan, but it may be possible to find a plan that helps cover massage therapy or other therapy services not covered by Original Medicare.

A licensed insurance agent can help you compare plans and get you enrolled in one that provides the benefits that are most important to you.

Find a Medicare Advantage plan that offers benefits that fit your lifestyle

Or call 1-800-557-6059TTY Users: 711 24/7 to speak with a licensed insurance agent.

About the author

Christian Worstell is a licensed insurance agent and a Senior Staff Writer for He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.

Where you’ve seen coverage of Christian’s research and reports:

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Do Medicare Advantage Plans Cover Chiropractic And Acupuncture

Medicare Advantage plansmay cover acupuncture or chiropractic care. Since MA are not standardized, each plan can offer a very different set of fees and benefits.

Plans that cover acupuncture are very rare but worth searching for if that is a high priority. Chiropractic is usually available under MA but how much you will pay can vary by plan.

For help tracking down supplemental insurance or if you have additional questions about alternative treatment, please call a Senior65 independent agent at 800-930-7956.

Medicare Part B Only Covers Certain Types Of Therapy

Does Medicare Cover Physical Therapy?

Medicare Part B pays for certain medically necessary forms of therapy, including some physical therapy, occupational therapy and speech-language pathology services.

In some cases, Medicare may also cover chiropractic services, but only if it’s considered medically necessary to correct a subluxation of the spine.

Even if a therapy service is covered by Medicare, there are annual coverage limits that may limit how many times you can get certain therapy services per year. If you go beyond the annual coverage limit and do not receive an exception, you will be responsible for the full amount of the service.

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Do You Have Coverage For Massage

Massage therapy may be defined in several different ways by an insurance company. How it is defined and the reason for getting the massage will determine whether you will be covered by your insurance.3 If a massage therapist treatment isnt covered in your policy, be sure and ask about these alternative options and discuss them with your doctor.

There is no standard requirement for insurance companies to reimburse expenses for massage. Massage therapy may be covered when:

  • The massage is considered medically necessary and/or fits the definition and criteria of coverage given by the health insurance company.
  • If the massage fits into the criteria of a habilitative or habilitation treatment, it may be covered by health insurance as an essential health benefit. You would have to speak with your doctor and your insurance company to be sure.

More health insurance companies are starting to cover massage therapy, so the first thing you need to do to find out if its covered in your situation is to ask your insurance company directly.

Does Medicare Advantage Cover Massage Therapy

People with Medicare Advantage health insurance may be covered for massage therapy. Medicare Advantage insurance is provided by private insurance companies and approved by Medicare. While it provides the same basic coverage as original Medicare Parts A and B, it may extend to a wider range of treatments depending on your provider.

Since 2019, many Medicare Advantage insurers have become more flexible around funding complementary treatments. Roughly 1.5 million Medicare Advantage beneficiaries are enrolled on a plan that covers massage therapy.

Most plans will require that your massage therapy is medically necessary and prescribed by an in-network physician before they will provide coverage. You will also need to find an in-network, licensed therapist to perform your treatment.

A key thing to consider if you want health insurance that covers massage therapy is whether it’s worth the cost of higher premiums. Medicare Advantage plans typically provide more comprehensive coverage than original Medicare, but they also tend to cost more. However, you may find that it’s cheaper overall to pay the higher monthly premiums than cover the costs of massage therapy yourself, especially if you anticipate needing frequent treatment.

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Medicare Part B: Limited Chiropractic Service Coverage

Medicare covers only a very limited selection of chiropractic services, of which are covered by Part B. As Part B is the part of Medicare that covers outpatient medical services, it makes sense that this coverage would apply to chiropractors. However, chiropractic services dont qualify as medical care in the ordinary sense, so Part B wont cover chiropractic services the same way it covers an ordinary doctors visit.

Billing Insurance For Massage Therapy

Massage Therapy: Does Medicare Cover It?

Regardless of your situation and insurance provider, you must have a recommendation from a doctor to treat a specific medical condition which includes the recommended number and length of massages. With that said, here are some instances in which you may be able to have insurance pay for some or all of your therapeutic massage treatments:

  • Health Savings Accounts : Some health insurance companies offer high deductible plans that may be paired with a health savings account. A health savings account is a bank account that you use to pay for qualified medical expenses with tax-deductible contributions . So while you are still paying out-of-pocket, there are substantial savings available through the tax advantages.
  • Personal Insurance Protection : This type of insurance is an extension of auto insurance plans and covers medical bills for injuries resulting from auto accidents.
  • Workers Compensation Insurance: Therapeutic massage for work related injuries can often be covered by workers compensation insurance. If youve been involved in an accident at work, check with your insurance provider to see if massage therapy is covered.

While these options are available to help cover the costs of therapeutic massage in North Carolina, only a small percent of the population can take advantage of them. If you feel that therapeutic massage for pain relief should be covered by health insurance in NC, I encourage you to with the North Carolina Department of Insurance.

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Services Covered By Msp

MSP is the provincial insurance program that pays for required medical services. These include medically necessary services provided by physicians and midwives, dental and oral surgery performed in a hospital, eye examinations if medically required and some orthodontic services. In addition, MSP pay for diagnostic services including x-rays. For information on laboratory service benefits under the Laboratory Services Act, visit the Laboratory Services website.

Other services that may be covered by MSP include supplementary benefits provided by other health care practitioners. These include acupuncture, chiropractic, massage therapy, naturopathy, physical therapy and non-surgical podiatry.

Medicare And Massage Therapy

Massage therapies can be highly beneficial for patients who suffer from joint and muscle disorders. Massage of body parts such as the back, neck, arms, and legs can help to relieve muscle stiffness in these regions.

It can also improve blood circulation in the bone, joint, and muscle tissues as well as skin thereby boosting the supply of oxygen and other nutrients to these parts.

This can speed up the healing and repair of damaged tissues and help to restore health in a shorter duration.

Hence, massage therapies are commonly included in the management of joint diseases like osteoarthritis, rheumatoid arthritis, and cervical and lumbar spondylosis.

It can also be beneficial for patients who experience muscle pains and stiffness due to a faulty posture or prolonged working hours.

If you would like to derive these benefits of massage therapies, it would be a good idea to first find out whether your Medicare plan covers these costs. Let us have a look at the coverage offered by Medicare for massage therapies and check if you can seek any other insurance plan for the same.

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Questions To Ask About Massage Therapy Coverage

If you learn that your insurer covers massage therapy, ask these questions so you will understand how your policy will cover it:

  • What are the conditions to qualify for reimbursement?
  • Is there is a deductible or any out-of-pocket cost to you?
  • Is there is a maximum amount payable per policy term/year?
  • Is there a maximum reimbursement per visit? For example, if the maximum per visit is $90, and you use a massage therapist who will charge $150, you will not be able to claim the full amount.
  • Is there a time limit per body region?
  • Are there specific massage therapists you must go to?
  • Do all types of massage qualify for coverage?

How Does Coverage For Massage Work

What Does Medicare Cover?

Once you know that your health insurance covers massage therapy, here are the important questions to ask so you understand how your policy will cover it:

  • What are the conditions to qualify for reimbursement?
  • Is there is a deductible, or any out-of-pocket cost to you?
  • Is there is a maximum amount payable per policy term ?
  • Is there a maximum reimbursement per visit? For example, if the maximum per visit is $90, and you use a massage therapist who will charge $150, you will not be able to claim the full amount and will have to pay the difference.
  • Is there a maximum time limit per body region .
  • Are there specific massage therapists you must go to?
  • Do all types of massage qualify for coverage?

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Medicare Supplement Plans And Massage Therapy

A Medicare Supplement plan pays your out-of-pocket costs under Part A and Part B. If a service is covered by Original Medicare, its also covered by your Medigap plan. All Medigap plans pay some or all of your Part B coinsurance.

In other words, if you get massage therapy from a licensed physical therapist, your Medigap plan will cover your share of the charges. In contrast, if you are treated by a massage therapist, your treatment isnt covered by Medigap.

Verifying Insurance Coverage & Reimbursement For Massage Therapy

At the current time, there is no standard coverage for massage therapy services within large insurance providers. This means getting coverage comes down to the reason for care and how that care is defined to the insurance company. Usually, if the treatment is medically necessary, or it fits the criteria of coverage provided by the insurance company, your client will be covered and you will be reimbursed. Additionally, if the services fit into the category of âhabilitative or habilitation treatment,â it may be considered an essential health benefit and your client will receive coverage. Many insurance companies deem massage therapy necessary in the acute phase of treatment, rather than as a long term care procedure.

An easy way to increase your chances of massage therapy being covered by insurance is to ask your clients to obtain a referral from their primary care physician. In a recent survey conducted by the American Massage Therapy Association, 67% of respondents indicated that their primary physician recommended they receive massage therapy. A prescription or referral from a physician is important for reimbursement because massage therapists are not licensed to diagnose medical conditions. With a referral from a doctor, the massage therapist can include the ICD-10 diagnostic code and referring provider on their CMS-1500 form, and increase their chances of reimbursement.

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Ways To Get Help Paying For A Massage

There are ways to save on getting a massage. Here are some of the top choices.

  • See if you can use HSA, FSA, or MSA funds towards your massage.
  • Look up Groupons, Living Social coupons, or other coupons for massages in your area.
  • Join a massage therapy spa to get discounts on treatments.
  • Get a massage at a massage training institute, where you can have a session with a student for as little as $20.00.
  • Put aside money each month in an account just for self-care activities for you.
  • Trade services you can do with a massage from a therapist you know.
  • Use a foam roller or massage ball at home to massage your muscles. You can find videos online that will offer you good massage tips with a foam roller or massage ball.
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