Does Medicare Cover Acupuncture?
This article was updated on: 09/10/2018
Are you interested in acupuncture as a complementary health treatment? Studies suggest it may help with pain and various health conditions, though we are only beginning to understand how acupuncture affects the body.
Original Medicare, Part A and Part B, does not cover acupuncture or other forms of alternative medicine. So, if you’re enrolled in Original Medicare, you’ll need to seek other ways to pay for acupuncture treatments, and you may need to pay for it out of pocket.
However, some Medicare Advantage plans may provide you with additional benefits, which may include acupuncture services. If getting coverage for acupuncture is important to you, you may want to find a plan that includes it. Learn more about acupuncture and Medicare coverage for this treatment.
What is acupuncture?
Acupuncture is a technique that stimulates specific points on the body to relieve pain—usually by inserting thin needles into the skin. It’s a practice used in traditional Chinese medicine. Research suggests that acupuncture may help manage chronic pain in the lower back, neck, or knees. It also may help reduce tension headaches and prevent migraines. However, please keep in mind that researchers are only beginning to understand its effectiveness.
Acupuncture is usually safe if performed by an experienced acupuncturist with sterile needles. If it’s done improperly, however, acupuncture can cause serious side effects. If you’re considering acupuncture, please note:
- Acupuncture may help some patients with pain management, but it shouldn’t be a substitute for consulting your doctor about your health problem. Talk with your doctor about whether acupuncture may be effective for your condition.
- Check the practitioner’s credentials.
- Ask the acupuncturist about how many treatments you’ll need and the cost.
- Inform your other health-care providers about all the forms of treatment and pain management you use, including acupuncture.
Original Medicare coverage of acupuncture
Medicare usually won’t cover services that aren’t “medically necessary,” and, currently, acupuncture isn’t covered under Original Medicare, Part A and Part B. If you have Original Medicare, you’d likely pay for acupuncture services out-of-pocket. If you’re planning to see an acupuncturist, it’s important to ask about the costs of the first and follow-up appointments, if there is a sliding scale based on income, how many appointments are necessary, and about additional costs.
Medicare Advantage coverage of acupuncture
As mentioned above, some Medicare plans called Medicare Advantage plans may include benefits not covered by Original Medicare. When you enroll in a Medicare Advantage plan, you’re still in the Medicare program and are required to pay your Part B premium along with any premium the plan charges.
A Medicare Advantage plan is offered by a private Medicare-approved insurance company and is required to provide at least the same level of coverage as Medicare Part A and Part B (except for hospice benefits, which remain covered under Part A). Some plans may offer extra coverage beyond Original Medicare, such as routine vision or dental, hearing, and/or health and wellness programs. Many Medicare Advantage plans also offer prescription drug coverage, and these plans serve as an alternative way to get your Original Medicare benefits and any extra coverage through a single health insurance plan.
Please keep in mind that not all Medicare Advantage plans cover the same services, and benefits may vary by plan. If your Medicare Advantage plan covers acupuncture, please note that some plans, such as HMOs, may also have rules about the providers you can use when receiving health-care services. Make sure to follow the rules of your plan, or you may have to pay higher costs; in some cases, you may have to pay for all of the costs when using non-network providers.
Medicare Advantage plans aren’t required to cover services that aren’t considered medically necessary under Original Medicare. If you aren’t sure whether acupuncture is covered, you can ask your Medicare Advantage plan for a written advance coverage decision to make sure a service is considered medically necessary and will be covered before you receive the service.
If you have any questions about your Medicare plan options or would like help finding Medicare Advantage plans that may cover acupuncture, just let me know. We can discuss some of your options in a one-on-one phone consultation, or I can email you some personalized options; use the links below to set that up. You can always look for plan options using our Find Your Plan button. You can also view my profile below to learn more about me.
For more information on acupuncture, see:
National Center for Complementary and Integrative Health, “Acupuncture: In Depth,” last updated January 2016, https://nccih.nih.gov/health/acupuncture/introduction