Does Medicare Cover Acupuncture?
Understanding Acupuncture & Medicare Benefits
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What is Acupuncture?
Acupuncture is a treatment derived from traditional Chinese medicine that involves thin needles being inserted through the skin at specific areas of the body. Traditional acupuncture was designed around the belief that a life force flows through the body and can get disrupted, causing illness. However, medical acupuncture has been proven to have beneficial effects based on science. The thin needles that are used stimulate sensory nerves under the skin and in the muscles, which encourages the body to release natural substances, like endorphins. These endorphins can relieve pain and discomfort.
Each session usually lasts between 20 minutes to an hour. The needles are incredibly fine and have been pre-sterilized. They should be disposed of once they’ve been used. The treatments may be uncomfortable, but they shouldn’t be overly painful. Acupuncture has been used to treat many conditions, particularly chronic pain. It has been known to help soothe neck pain, knee pain, and lower back pain. Some people have also reported that acupuncture can help relieve migraine headaches.
The effects of acupuncture on chronic pain can be surprisingly effective and long-lasting. Clinical trials have shown that around 90% of participants suffering from headaches or chronic pain have experienced pain relief lasting at least a year after their treatments. In recent years, acupuncture has been considered a potential alternative to other treatments for chronic pain, such as prescription opioids. Unlike medicinal painkillers, acupuncture rarely causes any side effects more severe than temporary pain and bleeding at the needle insertion site.
When performed by a qualified practitioner, acupuncture can be an effective and safe treatment for these conditions. It doesn’t harbor any risk of addiction or any significant side effects. It has also been used to treat other conditions, including depression and anxiety, although more research is required. So, if you plan to include acupuncture as part of your Medicare plan, please reach out to us, for free, at (888) 352-6672.
Does Medicare Cover Acupuncture?
Since January 2020, Medicare Part B began to cover acupuncture, albeit under very limited circumstances and for only limited visits per year. This new development was introduced in an attempt to provide alternative treatments to opioids for pain relief.
The acupuncture must be performed by a health care provider who has an accredited master’s or doctoral-level degree in acupuncture or Oriental medicine and who has a current and unrestricted license to practice acupuncture in your area.
Medicare will only cover acupuncture treatments for patients who are suffering from chronic lower back pain. This back pain must have lasted at least 12 weeks and have no known cause. Acupuncture is not covered if the pain is associated with surgery, pregnancy, or an inflammatory disease.
Original Medicare covers up to 12 visits in 90 days. Then, depending on how your condition is progressing, your doctor may recommend more treatments. If you’re improving, Medicare will cover another 8 treatments. If your doctor doesn’t think the acupuncture is helping, these additional treatments won’t be covered. In any case, Medicare covers a maximum of 20 visits per year.
If you’d like acupuncture under other circumstances, it may be beneficial to consider a Medicare Advantage plan.
Medicare Advantage Plans & Acupuncture
Medicare Advantage plans, otherwise known as Medicare Part C plans, offer at least the same coverage as Medicare Part A and Part B. They also offer additional benefits, so it’s worth perusing the details of the plan to see whether it covers the treatments that you want.
Depending on the plan you choose, you may need to be referred to an acupuncture professional before the costs are covered. A deductible and copayment may still apply for these services. You might also have a limited network of providers to choose from, which may include acupuncture professionals.
However, you may find that you are covered for acupuncture treatments designed for other conditions. These include migraines, chronic tension headaches, joint pain, neck pain, and others.
Medicare & Other Treatments
Acupuncture isn’t the only treatment for chronic back pain covered by Medicare designed to reduce reliance on opioids. These treatments are also covered by Medicare Advantage.
Chiropractic care is covered by Medicare when they treat a condition known as subluxation. Subluxation describes a misalignment of the spinal bones that exerts strain or pressure on the nerves in the back, which causes pain.
Medicare also pays for outpatient physical therapy when it’s medically necessary. For example, a doctor may recommend physical therapy designed to strengthen and stretch back muscles. This treatment reduces tension and pain.
If your doctor does recommend medication to control back pain, then it may be covered under Medicare Part D or a Medicare Advantage plan. But, make sure the penalties associated with Medicare Part D are worth it for your specific situation.
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A licensed insurance agent from our team will contact you to discuss your Medicare options.
