Sometimes, people think of medicines they have to buy from pharmacies when they hear the word prescription. But the term also applies to other things to help with your medical condition, such as massage therapies.
Your doctor can prescribe massage therapies to help you manage your medical conditions.
Massage therapies have been found to offer a lot of health benefits, such as improving circulation, relieving pain, stress, muscle tension, and even anxiety. They fall under the complementary and alternative medicines (CAM), which are used in addition to other medical treatments.
If you have an ailment, injury, or other health condition, you’re probably thinking of undergoing massage therapy. You believe that it can help you relieve your symptoms and make your condition more manageable. But will your insurer cover this treatment?
When Will Your Insurer Cover Massage Therapy?
Many people are turning to massage therapy to treat their medical condition but not all insurance policies cover them.
Insurers have a different definition of massage therapies. The reason why you want or need to get the treatment will determine if your insurance policy will cover it or not.
As of now, there’s no standard insurance policy that covers massage therapy services. It all depends on your insurance company.
Here are some cases where massage therapy may be covered by your insurance plan:
- If it’s prescribed or recommended by your doctor or medical professional
- If it’s considered medically necessary
- If it fits the criteria set by your insurance company
- If it falls under the “habilitative or habilitation” treatment category
- If it’s necessary during the acute phase of your medical treatment
When Can Your Doctor Prescribe Massage Therapy?
Massage therapy can be prescribed by your doctor. As previously mentioned, insurance companies are more likely to cover massage therapies if they’re prescribed or considered as medically necessary.
Several doctors are also turning to massage therapies as a complementary option to help their patients. A survey by American Massage Therapy (AMTA) found that many patients have been recommended by their doctors to get a massage.
You can ask your doctor if they can prescribe massage therapy if you have the following conditions:
- Sports injuries
- Soft tissue sprains
- Temporomandibular joint pain
- Nerve pain
- Myofascial pain syndrome
What Forms of Massage Therapy Are Covered by Insurance?
Some health care providers, like chiropractors, osteopaths, physical therapists, and occupational therapists use massage techniques in their services.
In these instances, your insurance plan may cover your visit with these specialists. However, it doesn’t include massage therapists.
That’s why it’s best to call your insurer first before you book an appointment for massage therapy. Knowing if it’s covered and how much it’ll cost you will give you an idea of whether you can afford it or not.
Which Insurance Companies Cover Massage Therapy?
As mentioned, not all insurance companies cover massage therapy. Listed below is a list of common insurance companies and whether or not they cover massage therapies.
|Does It Cover Massage Therapy?
|Cigna covers massage therapies as long as they’re used together with other approved treatments, such as physical therapy.
|Blue Cross/Blue Shield
|Blue Cross/Blue Shield covers massage therapy under its Service Benefit Plan.
|Unfortunately, Anthem Blue Cross and Blue Shield don’t cover massage treatments and other forms of therapies such as aromatherapy and acupuncture.
|United Health Care
|Yes, United Health offers coverage for massage therapies.
|Kaiser insurance covers massage therapy as long as it comes with a referral from a Kaiser Permanente doctor or accredited health care professional.
|The UPMC Health Plan doesn’t cover massage therapy, along with other services, such as homeopathy, herbal medicine, and aromatherapy.
|Aetna offers health insurance plans that cover some of the cost of massage therapy.
|Most Medicaid plans don’t cover massage therapies. They fall under the Alternative and Complementary Medicine category, and unfortunately, this type of treatment isn’t defined as a widely accepted medical practice or as an essential benefit under the Affordable Care Act (ACA).
|Medicare doesn’t cover massage therapy. If you decide to get one, you will pay 100% of the costs. Even if your insurance plan covers this treatment, there will still be some limitations.
How Can You Confirm If Massage Therapy Is Covered by Your Insurance Policy?
Before you book a massage therapy session, you need to make sure that your insurer will cover the treatment.
- Call your insurance provider and ask if massage therapies are included in your policy.
- Call a massage therapist and ask if they can help you get the treatment covered.
What Are the Questions You Need to Ask Your Insurer About the Coverage for Massage Therapy?
After you’ve confirmed that your insurer covers massage therapies, there are a few other questions you need to ask. This will help you understand how your insurance policy works in terms of getting this type of treatment.
- What are the requirements you need to meet to qualify for reimbursement?
- Is there any out-of-pocket cost? How much do you need to pay?
- What is the maximum amount that your plan will cover for every visit?
- What is the annual maximum amount payable for every policy term?
- What is the maximum time limit for the massage therapy session? What is the session time limit for each body region?
- Is there a list of massage therapists whose services are covered by your insurance plan?
- What types of massages are covered?
How Can You Get Your Massage Therapy Covered by Your Insurance?
Although there’s no guarantee that your insurance company will cover it, there’s something you can do to increase your chances of getting coverage.
Your doctor has to prescribe or recommend the massage therapy for it to be covered by your insurance. Your medical health professional like a primary care physician or chiropractor must issue a prescription to prove that massage therapy is a medical necessity.
A prescription is different from a referral, which is only an order from the doctor that allows you to see a specialist. A prescription includes important information, such as the diagnosis codes, number of visits, and the start/end date of the treatment.
How Can You Find a Massage Therapist That Accepts Your Insurance Plan?
If your insurance company covers massage therapies, ask your insurance network if you want to know which massage therapists near you accept your insurance plan.
Don’t forget to ask if they require a doctor referral. Confirm that they accept your coverage first before visiting them.
Are There Any Alternatives If Your Insurance Doesn’t Cover Massage Therapy?
Be open to looking for alternatives in case the massage treatment isn’t covered by your insurance plan.
Ask your doctor for options. They may provide you with another form of treatment that’s as effective as getting massages but is covered by your insurance policy.
Use your health savings account (HSA) or flexible spending accounts (FSA).
The HSA and FSA are common bank accounts set up by employees through their employers to deposit a certain amount of pre-tax money, which they can use for qualified health care expenses. They may cover the costs of your massage therapy if it’s deemed medically necessary.
How to Get Massage Therapy for Cheap?
An insurance policy that covers more services costs more than those that don’t. The premium of the insurance plan also varies from one insurer to another.
How much you need to pay for your massage therapy will depend on whether or not it’s covered by your insurance. Call your insurance company to know if you will get reimbursed and how much is your deductible.
You may find affordable services through the following:
- Look for local massage schools that offer massage therapy services at affordable or discounted prices.
- Ask massage service providers if they have special deals, or if they offer discounted rates.
- Find a licensed massage therapist that offers discounts for clients who pay cash upfront or those that offer low-cost installment repayment plans.
There’s no standard insurance plan that covers massage therapies. Most of the time, it needs to be deemed as medically necessary or must be prescribed by your medical professional to be covered by insurance. Otherwise, you’ll have to pay for it out of your pocket.
Even if your insurance plan covers this treatment, there will be some restrictions like a limit on the amount payable during a policy term. It’s best to verify with your insurance provider first before you get massage therapy.