- Medicare considers massage therapy an alternative treatment. That means it’s not covered by original Medicare (parts A and B).
- Medicare Part B does cover some types of therapy, including physical therapy and acupuncture for certain conditions.
- Medicare Advantage (Part C) plans might cover some of the costs of massage therapy. In those cases, you’ll need orders from your physician to receive coverage.
Massage therapy is a treatment that manipulates the soft tissues in your body. It’s often used for relaxation but can also be beneficial for some health conditions.
For example, it can:
- boost circulation
- reduce muscle and joint pain
- increase flexibility
Medicare considers massage therapy an “alternative treatment,” so it’s not deemed medically necessary. That’s why original Medicare (parts A and B) won’t pay for massage therapy sessions.
Some Medicare Advantage (Part C) plans, on the other hand, might cover massage treatments.
In this article, we’ll review when massage therapy could be paid for by a Medicare plan and what you’ll need to do to get the cost covered.
Original Medicare doesn’t cover the cost of massage therapy.
The Centers for Medicare & Medicaid Services (CMS), the federal agency that runs Medicare, has classified massage therapy as an “alternative and complementary medicine.” As such, Medicare doesn’t pay for massage therapy, even if you use it to treat medical issues.
If you have original Medicare, you’ll be responsible for 100 percent of the costs of massage therapy out of pocket. Typical massage therapy sessions cost about $60 per hour. Costs vary by region, massage type, and gratuity.
What if I have Medicare Advantage?
While original Medicare doesn’t cover massage therapy, some Medicare Advantage (Part C) plans may.
Medicare Advantage plans are private insurance plans. They’re approved by Medicare, and they cover everything original Medicare does. However, these plans often extend coverage to other areas of treatment, including vision and dental care.
As of 2019, therapeutic massage is covered as a supplemental benefit under some Medicare Advantage plans. According to CMS, about 270 Medicare Advantage plans offer massage coverage, covering nearly 1.5 million enrollees.
For Medicare Advantage to cover massage therapy, you’ll need to:
- Seek treatment for a condition that’s related to an injury or illness, such as chronic pain or limited mobility.
- Get an order or prescription from an in-network doctor for massage therapy to treat a covered medical condition.
- Find a state-licensed massage therapist who’s registered with your plan’s network and has a National Provider Identifier.
Your Medicare Advantage plan may not cover 100 percent of the costs of your massage therapy. You may still owe a copayment or deductible.
What’s more, Medicare Advantage plans with these additional areas of coverage often cost more than more limited plans. However, those higher plan costs may be offset by the costs they cover for additional benefits.
If you think you’ll need insurance coverage for massage therapy, search for a Medicare Part C plan that offers this benefit. Medicare offers an online tool to help you see what your coverage options are and purchase a plan that’s right for you.
What about Medigap?
Medigap, or Medicare supplement insurance, is a plan that pays the cost of deductibles and copayments from original Medicare.
Medigap plans pay for costs from original Medicare only. Since original Medicare doesn’t pay for massage therapy, Medigap plans won’t pay for that service either.
However, Medigap may pay for any leftover expenses from other covered therapies, such as chiropractic treatments and physical therapy.
While Medicare doesn’t cover massage therapy, Part B will cover some other types of therapeutic treatments. Let’s take a look at what types of therapy are covered, costs, and eligibility rules.
Physical therapy can be an effective alternative to massage therapy. It can help you regain range of motion, recover from an injury, relieve pain, and more. Physical therapy may also be helpful in treating or recovering from conditions like stroke, Parkinson’s disease, and chronic pain.
Medicare Part B covers medically necessary outpatient physical therapy. After you’ve met your Part B deductible, Medicare will cover 80 percent of the costs. You’ll pay the remaining 20 percent out of pocket or use your Medigap plan to cover them.
A Medicare-approved physician will have to refer you to a physical therapist or specialist who can treat you with this type of therapy. A doctor’s order or a prescription may be needed.
Medicare Part B offers limited coverage for chiropractic services. Costs of chiropractor visits may be covered if you’re receiving spinal manipulation, or an “adjustment.” However, Medicare doesn’t cover tests or services ordered by a chiropractor, including X-rays.
Medicare will pay for adjustments only if you’ve been diagnosed with spinal subluxation. This is a condition that occurs when bones move in your spine and are out of position. You’ll need an official diagnosis from a chiropractor. Any other diagnosis will not be covered.
For approved treatments, Medicare Part B covers 80 percent of your costs after you’ve met your deductible. You’re responsible for the remaining 20 percent.
If you have Medicare Advantage, your plan may cover additional chiropractic care.
Medicare Part B does pay for acupuncture for some conditions. Medicare currently covers 12 sessions within a 90-day period. But they can only be used for the treatment of chronic lower back pain.
More visits (up to 20 sessions in total) may be covered in a calendar year. Medicare must approve these 8 additional visits before you have them.
If you’re interested in this type of treatment, you’ll need to find a qualified, licensed medical practitioner. If you seek treatments from practitioners who don’t meet Medicare’s requirements, the visit may not be covered.
Again, Medicare will cover 80 percent of the cost of these services when the coverage rules and your deductible have been met. You’ll pay the remaining 20 percent out of pocket.
Massage therapy is the practice of rubbing and kneading your body’s soft tissues. It may focus on a specific part of your body to help relieve pain. It can also be done all over your body for a relaxing, therapeutic effect.
Massage therapy can be helpful for a variety of conditions and ailments. The benefits of massage therapy include:
- increased flexibility
- improved joint mobility
- reduced muscle and joint pain
- increased circulation
- fewer headaches and migraines
Massage therapy may also be beneficial for certain conditions, including arthritis, cancer-related pain, carpal tunnel, muscle strain from an injury, and more.
- Original Medicare (parts A and B) doesn’t cover massage therapy, but it can cover other therapies like physical therapy and acupuncture.
- If you use massage therapy without Medicare coverage, you’ll be responsible for 100 percent of the costs.
- Medicare Advantage (Part C) may offer some coverage for massage therapy.
- You can seek out a Medicare Advantage plan that covers massage therapy. It may be more expensive than other Part C plans, but the additional coverage may offset your out-of-pocket costs.