Generally, Original Medicare does not cover massage therapy. However, if massage therapy is considered medically necessary by your doctor and is a part of official treatment plan, Medicare Part B will step in and cover 80% of the costs. Most Medicare Part C plans also offer massage therapy coverage if it’s medically necessary and is prescribed by a healthcare professional.

Original Medicare and massage therapy: what is covered and what is not?

Massage therapy is a popular form of manual therapy that alleviates pain, relieves stress, and makes you feel energized. However, depending on the location, a massage session costs $50 to $150 per hour. 

This makes things difficult for seniors who wish to integrate this form of therapy into their wellness routine. And so, we hear a common question time and time again – does Medicare cover massage?

The answer is no, in most cases Original Medicare (Part A and B) does not cover massage therapy. It doesn’t matter whether the massage is medically important for you or not. Medicare will not pay for this healthcare service. 

However, there is one exception – the massage is a part of medical treatment, and it is not billed separately.  

In this particular case, Medicare Part B will cover massage therapy costs at 80%. You will pay the remaining 20%.

Does Medicare Part C cover massage therapy?

Medicare Part C (also called Medicare Advantage) is different from Original Medicare. It offers the benefits of both Part A and B – along with additional perks like vision and dental. You can purchase it from private insurance companies. 

Some Medicare Advantage plans may also offer coverage for certain types of alternative therapies, including massage therapy. But this can vary widely depending on the specific plan and the insurance company offering it. 

So, it’s important to review the details of the Medicare Advantage plan you are considering and make the decision accordingly.

Eligibility criteria 

To qualify for Medicare massage therapy coverage, you must meet the following general requirements:

• Massage therapy is medically necessary to treat a health condition.
• You have a written prescription from your doctor.
• Your massage therapist accepts Medicare assignments. 

Please note the criteria for massage therapy coverage are not the same everywhere. Some insurance companies may have more requirements. So, it’s best to contact your plan provider and confirm the details. 

How much does massage therapy cost with Medicare?

If you qualify for the massage therapy coverage as described above, know that Medicare will still not pay 100% of the cost. 

You must pay a portion of it. Have a look at these factors to determine exactly how much will massage therapy cost with Medicare:

• Medicare Plan

If you are receiving massage therapy as part of a medical treatment, Medicare Part B may step in and pay 80% of the total amount. So, if an hour-long session is for $50, Medicare will pay $40 and you will pay $10. 

That being said, your Part B annual deductible should be cleared. This is the amount you must pay for medical services before Medicare starts covering the payment at 80%. In 2023, the annual deductible is $226 and in 2024 it will be $240.  

As for Medicare Advantage enrollees, the coverage will greatly vary from company to company. 

• Supplemental insurances

Medicare allows you to pay for deductibles and co-payments using supplemental insurance plans. This includes Medigap, Medicaid, and Tricare. You can use these insurance plans to lower massage therapy costs. 

What is massage therapy?

Massage therapy is a hands-on technique that involves the manipulation of soft tissues in the body, including muscles, tendons, ligaments, and connective tissues. During a massage session, a trained therapist applies various techniques such as kneading, rubbing, and applying pressure to different areas of the body. This can help alleviate muscle tension, promote relaxation, improve circulation, and reduce stress.

Massage therapy can be used to address a wide range of health issues, including muscle pain, stress-related conditions, headaches, and even certain medical conditions like high blood pressure.

FAQs

Does Medicare cover therapeutic massage?

Medicare does not cover massage therapy for general relaxation or stress relief. However, there may be specific situations where it could be covered – like the massage being a part of a bigger medically necessary treatment. 

Does Medicare cover deep tissue massage?

No, Medicare will not cover deep tissue massage because it’s a type of therapeutic massage technique. It focuses on applying sustained pressure and slow strokes to relieve chronic tension that has formed in the muscles.

Does Medicare cover medical massage?

A medical massage is administered with the intent of addressing a diagnosed medical condition under the guidance of a healthcare provider. It is typically prescribed as part of a treatment plan to alleviate health issues. So, yes, Medicare will cover it. 

Does Medicare cover massage therapy for back pain?

Medicare may cover massage therapy for back pain if it is medically necessary and prescribed by a healthcare provider as part of a medical treatment plan. You won’t receive coverage if massage therapy is billed as a separate treatment.

Does Medicare cover massage therapy for fibromyalgia?

Fibromyalgia is a chronic pain disorder that is characterized by sleep disturbances, headaches, and tenderness in some areas of the body. 

So, if a professional determines that massage therapy must be included in your fibromyalgia treatment plan, it may be covered by Medicare.

Summary 

To sum it up, Original Medicare doesn’t cover massage therapy unless:

• It’s a part of a medical treatment plan. 
• It’s not billed separately.
• It’s performed by a professional who accepts Medicare assignments. 

If you meet the criteria, Medicare Part B will pay 80% of the total amount and you will pay the remaining 20%.

Most Medicare Part C plans offer massage therapy, but the extent to which the service will be covered depends on your specific plan. So, choose wisely!

Need help? Contact HellaHealth to help you select the right Medicare plan today!