Will Medicare Cover Your Acupuncture Treatments?

Are you dealing with chronic pain? If so, you likely feel frustrated, angry, and possibly, hopeless. Not to mention the constant discomfort you’re facing can lead to anxiety and depression. Unfortunately, chronic pain keeps many seniors from enjoying their lives to the fullest. 

While there’s often not a perfect solution to this problem, there are ways to manage and alleviate your pain—even without medication. Reducing stress, exercising regularly, changing your diet, and eliminating smoking and drinking can all improve your health.

But there may be yet another way: acupuncture. 

Acupuncture has entered the mainstream in recent years as a major method of pain reduction. This treatment has roots in traditional Chinese medicine and recent scientific studies show it may be helpful in relieving chronic pain. 

If you think acupuncture is more in the “self-care” category than the “medical” category–think again! Many insurance providers, including Medicare, cover acupuncture treatments. So if you have chronic pain and are enrolled in a Medicare Part B plan, there may be treatment options available to you.

What is acupuncture? 

In addition to pain, acupuncture may be used to treat migraines, nausea, and addiction, among other conditions. Thought to tap into the body’s natural healing systems, you might hear acupuncture explained as a method of bringing about balance or flow. Western physiology explains that acupuncture may work by stimulating nerve transmission and helping different parts of the body talk to each other. 

You might have a vision of acupuncture from television. If so, your perception of acupuncture might involve a lot of needles in the face and other sensitive parts of the body. Although acupuncture does use needles, they are very tiny and don’t hurt. And most practitioners won’t start small, not with a whole handful.

Acupuncture is considered a safe treatment when performed by a qualified practitioner. If you’re nervous, don’t be afraid to start slow and ask questions! 

Does Medicare cover acupuncture?

If you’re on Medicare Part B, you already have access to acupuncture treatment through your health insurance plan. This coverage may come as a surprise, although currently, Medicare only covers acupuncture for chronic lower back pain.

If you’re experiencing chronic lower back pain, you can get 12 acupuncture visits in a 90-day period to help ease your symptoms. If you’re showing improvement, you can qualify for an additional eight sessions. But if you aren’t showing improvement, Medicare won’t approve those additional sessions. Either way, the maximum number of acupuncture treatments Medicare covers per year is 20. 

For those on Medicare Advantage, at a minimum, you’ll be provided the same acupuncture coverage as Original Medicare. Your plan may provide additional benefits, though, so check with your agent to determine what services you’re eligible for.

What are the requirements?

As mentioned above, Medicare specifically covers acupuncture for chronic lower back pain. But what symptoms actually qualify for these treatments? 

Medicare defines chronic lower back pain as 

• lasting at least 12 weeks and
• having no known cause like disease or surgery. 

If your back pain meets these conditions, then you may be able to access acupuncture through your Medicare Part B plan. The next step is to get acupuncture from a healthcare provider who meets the following requirements. Your provider needs to

• have a master’s degree or higher in acupuncture or Oriental Medicine from a school accredited by the Accreditation Commission on Acupuncture and Oriental Medicine, or 
• have a current, full, active and unrestricted license to practice acupuncture in the state where you will receive care. 

What should I do next? 

If you’re experiencing chronic lower back pain and are interested in the acupuncture treatments covered by Medicare Part B, find a provider in your area who meets the above requirements. For questions about your Medicare coverage, get in touch with us at 877.255.6273.

 

image credit: shutterstock/JPC-PROD