Will insurance pay for Massage Therapy?
The short answer to this question is, “Yes, but…”
In all cases, a prescription for massage from your physician, with a specific diagnosis, is required for insurance coverage. Currently, we do not directly submit claims to health insurance companies due to the inconsistency of coverage for therapeutic or medical massage. Although the majority of what we do at Asclepieion Massage Therapy is therapeutic or medical in nature, healthcare is rapidly changing! Insurance companies in Florida, Washington and Oregon now include massage as a covered benefit on many policies. And, starting in 2019, the new Medicare Advantage plans will cover massage in Arizona!
How Do I Get My Doctor to Approve Massage for Insurance Reimbursement?
Step 1 – Read through your health insurance policy to verify that your health insurance covers medically necessary massage. Unfortunately, most insurance policies do not cover massage, doctor prescribed or not. So, make sure you are covered before having that conversation with your physician. Alternatively, you may be able to use your Health Savings Account (HSA) or Flex Spending Account (FSA) if you have one. Lastly, you can pay out of pocket. The reality is that when compared to the cumulative costs of copays, deductibles, insurance premiums and prescriptions for conventional "solutions,” the out of pocket costs for most alternative care treatments like therapeutic massage are much less expensive and often more effective.
Step 2 – Research the possibility that massage therapy is a good choice for treatment for your condition. If it is not a well-known or recognized treatment for your condition or injury, your doctor will likely be hesitant to give you the go-ahead to pursue prescribed massage therapy as a treatment. You may need to print copies of case studies to show for evidence; for instance, the Journal of Alternative Complementary Medicine recommends massage therapy for cancer care treatment.
Step 3 - Visit your doctor and speak with them about your symptoms and options for your treatment. It's likely that your doctor will suggest more traditional options before suggesting massage therapy, so you may need to bring it up yourself. Explain why you'd like to receive therapeutic massage and cite successful cases in which massage therapy has been used to treat similar conditions.
Step 4 - Discuss potential massage therapists, like us, that have a healthcare background and do rehabilitative, therapeutic or medical massage. If you have any questions, or would like us to speak to your doctor, we’d be happy to discuss our philosophy, training or techniques with you or anyone on your healthcare team.
Step 5 – Once your doctor writes your prescription, we will need a copy, and then send another copy of the prescription along with your massage therapy receipts to your insurance company for reimbursement.
Flexible Spending Account (FSA) or Health Savings Account (HSA)
If you participate in a Flexible Spending Account (FSA) or Health Savings Account (HSA), your tax-free contributions to the plan can be used for qualified medical expenses not normally covered by health insurance, including therapeutic massage treatment. Although not always necessary, it is best to have a prescription for therapeutic massage from your physician to ensure FSA/HSA approval. A prescription for massage ensures that your treatment will be considered medically necessary. Some FSA/HSA programs provide a debit/credit card to use for payment of medical expenses which deducts the funds directly from your account. If this is not the case for you, we will provide a detailed receipt for you to submit a claim for reimbursement of charges.
Workers compensation coverage usually covers medical bills, rehabilitation treatment, and loss of income, if an employee is injured on the job. In this case, if medical or therapeutic massage is required and recommended as part of the overall treatment plan, then the insurance provider must approve the treatment before payment will be made. In addition, the referral for massage therapy must state the length of time or number of sessions which has been approved, and the type of massage that has been prescribed by the attending physician.
Depending on the location and the type of coverage, below are some medical insurance companies that may cover medical massage therapy. Some insurance companies that may pay for therapeutic massage in full or in part include providers, such as: Aetna, Blue Cross/Blue Shield, Humana. Please refer to the steps above to ensure you are have prior approval before scheduling and appointment with us. Please note that our office does not directly bill your insurance company or accept medical liens against future insurance settlements. We will be happy to provide you with a receipt and the procedure codes necessary for you to submit your own claim to insurance for reimbursement of charges incurred.
If you have any questions, or would like additional information, please give our office a call. We look forward to working with you.