Millions of acupuncture treatments are administered in the U.S. each year. Acupuncture isn’t suitable for everyone, but it has gained enough attention that we want to talk about it. Here’s what you should know about Medicare coverage for acupuncture treatments.
What Is Acupuncture?
It’s a body stimulation technique. Practitioners often insert thin, sterile needles through the skin — in targeted areas — known as acupoints.
Why Is Acupuncture Done?
Acupuncture is meant to improve your body’s functions and promote self-healing. It can relieve discomfort that results from a variety of conditions and diseases, including:
- Neck pain
- Dental pain
- Osteoarthritis
- Low back pain
- Menstrual cramps
- Respiratory disorders
- Tension headaches and migraines
- Postoperative nausea and vomiting
Medicare and Acupuncture
Medicare only covers acupuncture as a way to treat chronic low back pain.
Medicare Part B is your medical insurance, covering a maximum of 12 acupuncture visits in 90 days. “Chronic low back pain” meets these criteria:
- It lasts 12 weeks or longer
- It doesn’t have a known cause like cancer or a disease
- It’s not connected to surgery or pregnancy
If you show signs of improvement, Medicare will cover an extra eight sessions. However, Medicare won’t cover treatments if your doctor determines that your back pain isn’t getting better or is worsening. Medicare will cover up to 20 acupuncture treatments per year.
Acupuncture Treatments Not Covered by Medicare
Unfortunately, Medicare doesn’t cover acupuncture to treat headaches, stress, neck pain, or relief from chemotherapy. Medicare doesn’t cover acupuncture for pain in other areas of the body. If you have chronic pain in places other than the low back, visit a pain management specialist. If a misaligned spine has caused pain, Medicare may cover chiropractic care.
Related Post: Medicare and Chiropractic Care – What’s Covered?
The Reasoning
The CMS decided to cover acupuncture for chronic low back pain because they want to support alternative pain therapies. They also don’t want patients to rely so much on opioid painkillers.
Alternative medicine is typically not covered by Medicare because it’s a nonconventional approach. It tends to lack credibility and is untestable, meaning there’s no scientific evidence to back up the claims. In other words, it can give you false hope.
Do Medicare Advantage Plans Offer Acupuncture?
Advantage plans differ by location. Not all will cover acupuncture, but UnitedHealthcare and Humana offer programs in certain areas with some acupuncture benefits. If you’d like to see which Medicare Advantage plans are available near you, reach out to an agent at TSS.
Do Medicare Supplement Plans Cover Acupuncture?
Medicare Supplements (Medigap) will cover anything that Original Medicare does. If Medicare approves the acupuncture, the supplement carrier will pay a percentage of the bill. However, when Medicare rejects coverage for treatment, Medigap will deny it, too.
Related Post: Four Ways to Modify Your Medicare Coverage
Learn More About Medicare Coverage
Whether you’re concerned about what Medicare doesn’t cover or want a plan that pays for alternative therapy treatments, we can help. TSS represents the top carriers, providing an objective opinion on your options. Let us tell you about the plans in your area! Call (855) 952-1941 to find the best policy for you.
