Does Medicare cover chiropractors is a common question that we get. Let’s face it, sometimes alternative types of care work better to relieve pain faster than traditional for some folks.
Eastern medicine has gained a lot of popularity over the past 50 years in the U.S.
It is very common for people to seek out complete health and body treatments from a Chiropractor, Acupuncturist, Yoga instructor, Physical therapist, or Masseuse.
While many people sing the health and healing benefits of these long-practiced medical arts, Medicare is a bit more skeptical and only covers some of their services.
We will look at what Medicare covers for Chiropractic services, Acupuncture, Yoga, Physical Therapy, and Massage.
Does Medicare Cover Chiropractors?
Pain management and health care services come in many forms for many people with Chiropractic Services being a favorite.
If fact, it is estimated that 35 million adults are treated by Chiropractors each year in America.
So it might come as quite a surprise to learn that generally, Chiropractic services are not covered by Medicare.
Of course, just like everything else with Medicare, there is one exception…
Medicare will cover Chiropractic treatments for subluxation, which is a condition where the bones in your spine are out of position.
Subluxation can vary in debilitation and can cause severe joint pain, muscle pain, and cause migraine headaches.
For Medicare to cover your Chiropractic services, your medical doctor must prescribe the treatment.
Medicare Part B will pay 80% of Medicare-approved charges, and you will be responsible for the remaining 20%.
While your doctor and chiropractor may prescribe a lengthy treatment plan, Medicare will only pay for a minimal number of sessions. So when you ask if “Does Medicare cover Chiropractors?”…the answer is mainly No (unless you qualify under subluxation).
Speak with a Senior Benefits Medicare expert today to find out more.
Does Medicare Cover Acupuncture?
Acupuncture has grown in popularity since coming to the U.S. from China.
Research has shown that it can relieve pain and nausea by helping the flow of energy, called ‘qi’.
Skilled professionals are able to help that flow by inserting metallic needles into the skin with the intent of relieving pain or other ailments.
Scientists are unsure how it works, however, many studies have shown acupuncture to be very effective in treating health issues, such as:
- Lower back pain
- Headaches
- Osteoarthritis
- Nausea
Because of these benefits, it makes sense to combine this treatment with others if you feel it is effective.
However, Medicare does not believe that acupuncture is ‘Medically Necessary’ for most treatments other than chronic lower back pain. Chronic low back pain is defined as:
- Lasts 12 weeks or longer
- Has no known cause (for example it is not related to another known disease, infection, etc)
- Is not associated with a surgery or preganancy
Now that you know that Medicare will cover acupuncture for chronic low back pain, it is important to go see the right provider. Medicare states that you must get acupuncture from a health provider that has both of these:
- A masters or doctoral level degree in acupuncture or Oriental Medicine from a school accredited by the Accreditation Commission on Acupuncture and Oriental Medicine
- A current, full, active, and unrestricted license to practice acupuncture in the state where you’re getting care
So what does Medicare pay for acupuncture?
Medicare will cover up to 12 acupuncture treatments in 90 days for chronic low back pain (see definition above). If you show improvement then Medicare will pay for an additional 8 sessions. You can get a maximum of 20 acupuncture treatments in a 12-month period.
What if you don’t show improvement at 12 treatments?
You will be responsible for 100% of your additional acupuncture treatments after the original 12 treatments.
Does Medicare Cover Physical Therapy?
Medicare B covers medically necessary outpatient therapy.
In previous years Medicare put a cap on how much physical therapy they would pay in a calendar year.
However, as of 2019, there is no longer a cap on how much they will pay for medically necessary PT.
Keep in mind that you can receive up to $2,040 in physical therapy a year before having to provide a note from your doctor saying it is medically necessary.
Original Medicare Part B covers 80% of Medicare-approved costs, and you will be responsible for the other 20% unless you have supplemental insurance.
To help offset the costs of Original Medicare, you can purchase Medigap plans that can cover some or all of the additional expenses Medicare does not.
Speak with a Senior Benefits Medicare expert today about your health care options.
Does Medicare Cover Yoga?
While fitness and exercise play a large role in your overall health, Original Medicare does not cover yoga, fitness programs, or gym memberships.
To get coverage for exercise programs, you will need to get additional coverage from a Medicare Supplement Plan.
Many supplements include gym memberships and access to programs like Silver Sneakers.
Yoga has been proven to have tremendous health benefits and reduces your chance of injury in the event of a fall.
Contact a Senior Benefits expert to discuss enrolling in a supplement plan that includes yoga coverage.
Does Medicare Cover Massage?
Technically, Medicare does not cover massages because it is considered an alternative therapy.
As an alternative therapy, it is not deemed medically necessary, and so, it is not included.
But, I did say ‘technically’ because if you are receiving physical or occupational therapy, one element of those sessions is a massage.
The reason Medicare doesn’t cover therapeutic massage is that it is considered alternative or complementary medicine.
According to the Affordable Care Act, massage therapy isn’t defined as an essential benefit or widely accepted medical practice.
Therefore, it is very difficult to justify treatment from an insurance standpoint.
Take Action!
Now you are armed with information about the various therapy coverages Medicare provides and can plan accordingly.
Many of these services can be covered by alternative health insurance plans or supplemental plans.
Contact a Senior Benefits Medicare expert today to discuss all of your options at (800)924-4727