Acupuncture is a holistic remedy that has been practiced for thousands of years. Medical literature indicates that acupuncture may be an effective treatment for acute and chronic pain. However, acupuncture has yet to become an accepted replacement for more traditional treatment in Western medicine.
Many insurance providers refuse to cover acupuncture, and Medicare is one of them. While the medical community is becoming more open to alternative treatment and holistic remedies, insurance companies in the United States haven’t.
As a general rule, Medicare denies requests for coverage of “alternative” (also called “integrative” or “complementary”) medical treatments. But there may be some exceptions to this policy.
At this time, Medicare doesn’t cover acupuncture treatments.
In 2019, Medicare announced one exception to this rule. People enrolled in studies for chronic lower back pain may have coverage for acupuncture treatments. However, the study must meet strict requirements, and coverage will cease once the study ends.
According to Medicare, while evidence for the use of acupuncture for lower back pain is growing, they still have questions about how it works and how effective it is.
At this time, Medicare doesn’t cover massage therapy, even in instances when it’s prescribed by your doctor.
Medicare covers adjustments to your spine performed by a chiropractor. If you have a diagnosis of a slipped bone in your spine, you may be eligible for medically necessary chiropractic treatments.
According to Medicare’s policies, you’ll still be responsible for 20 percent of the treatment’s cost until you meet your yearly deductible.
Medicare doesn’t cover other services a chiropractor might provide or prescribe, such as acupuncture and massage.
Medicare Part B covers medically necessary physical therapy treatments. These treatments must be performed by a physical therapist who participates in Medicare and prescribed by a doctor who submits documentation showing that you need the treatment.
You’ll still be responsible for 20 percent of the treatment cost until you meet your yearly Part B deductible.
In addition to Medicare parts A and B, there are additional plans that you can purchase to increase your coverage.
Medicare Part C (Medicare Advantage) plans are private insurance plans that provide the benefits of Original Medicare combined with options from private insurance companies.
Part C may deny claims for alternative treatments. If you have a Medicare Advantage plan, you’ll need to ask your provider their policy for acupuncture and other alternative medical treatments.
Medigap supplement plans can be purchased to increase the benefits of traditional Medicare coverage. These supplement plans cover things like deductibles and other out-of-pocket medical expenses. However, Medigap plans don’t cover acupuncture.
Private insurance plans are the most likely to cover alternative therapies like acupuncture and yoga. While the initial cost of private insurance plans may be higher, these plans may reduce costs of alternative therapies.
It may be in your best interest to see if switching to private insurance could save money on treatment not covered by Medicare.
Acupuncture costs can vary according to your provider and where you live. Your first appointment may be the most expensive, as you will need to pay for the consultation fee as well as any treatment.
Expect to pay $100 or more for the initial treatment and between $50 and $75 for treatments after that. A
Because rates can vary, ask your practitioner how much your session will cost. Get an estimate in writing, if you can, before you agree to be treated by your chosen acupuncture provider.
Tips for navigating Medicare choices
Medicare can be confusing and hard to navigate. Whether you’re enrolling yourself or helping a loved one, here are some suggestions help during the process:
- Make a list of your medical conditions and all medications you take. Knowing your current medical needs will help when you search Medicare.gov or talk to the Social Security Administration.
- Search Medicare.gov for specific details on all Medicare plans. Medicare.gov has tools to help you search for coverage based on many factors, such as your age, location, income, and medical history.
- Contact the Social Security Administration for any questions. Medicare enrollment is managed by the Social Security Administration. Contact them before you enroll. You can call, look online, or schedule an in-person meeting.
- Take notes during any calls or meetings preparing for enrollment. These notes can help clarify information about healthcare and coverage.
- Make a budget. It’s important to know exactly how much you can afford to pay for your Medicare benefits.
Acupuncture may be an effective treatment for some health conditions that affect seniors, such as rheumatoid arthritis or chronic lower back pain.
However, until recently, Medicare didn’t cover the costs of acupuncture treatments at all. Currently, Medicare may cover acupuncture in very limited circumstance for research purposes.