Acupuncture and Chiropractic are alternative ways to help with pain management, as well as other wellness benefits – some people find acupuncture helps them to quit smoking. Out of pocket costs for chiropractic and acupuncture can be hard on your wallet, so many of my clients often ask if Medicare covers acupuncture and chiropractic?
Let’s Talk About Acupuncture First.
Medicare does not cover acupuncture. Medicare offers some coverage for physical, occupational, and speech therapy but no acupuncture as of yet. But don’t get discouraged by this answer! Some insurance plans do cover acupuncture. Read on.
Does Medicare Cover Chiropractic Care?
Medicare does cover medically necessary chiropractic services. According to the Center for Medicare & Medicaid Services (CMS), Medicare Part B now covers 80% of the cost for “manipulation of the spine to correct a subluxation.” There is no cap on the number of medically necessary visits to a chiropractor.
Under Original Medicare, without any additional insurance, you would have to pay your part B deductible and 20% coinsurance for all medically necessary chiropractic appointments.
Do Supplemental Plans Cover Chiropractic and Acupuncture?
Traditional Medicare Supplements (also known as Medigap plans) do not cover acupuncture either. These plans will help pay the left over costs once Medicare has paid their share so if it’s not covered by Medicare then the Medigap plan will not pay either.
Medigap plans do cover chiropractic care. Medigap plan “C” and plan “F” cover 100% of your Part B deductible and will also pay the 20% coinsurance. Combined with Medicare there will be no charge for any medically necessary chiropractic work.
Do Medicare Advantage Plans Cover Chiropractic and Acupuncture?
Yes, some plans in Maine and New Hampshire do offer coverage for these treatments and More!
Some Medicare Advantage (Part C) plans will reimburse you for certain services not covered by Original Medicare. These include Acupuncture, Dental, Fitness Benefits, and Naturopathic Services. Since Part C plans are not standardized, each plan can offer a very different set of fees and benefits. Plans that have these wellness benefits are rare but worth searching for if that is a high priority. Chiropractic is usually available with a Medicare Advantage plan but how much you will pay can vary by plan.
For help tracking down which Medicare Advantage plans offer the benefits you need or if you have additional questions about other alternative treatments, send me a message using the CONTACT ME page on the menu above or call me at 207-370-0143.
If you would like to talk to me or schedule a meeting at your home or a nearby meeting place, you can reach me at 207-370-0143 or use my simple form on the CONTACT ME page of this site to send an email message. The best part about working with me is that it will not cost you anything to meet with me to discuss your options or to review the plans that are available. I am paid by the insurance companies in the form of a commission if you enroll in a plan. You will not pay any more than anyone else and you are under no obligation whatsoever to enroll in any plans if you meet with me.
“My goal is to help you and I have found great joy in being able to offer my services to people who need my help.”
Before joining a Medicare Advantage Plan here are some important questions to ask.
When you are choosing between Medigap and Medicare Advantage or between Medicare Advantage Plans, here are some questions to keep in mind.
Providers, hospitals, and other facilities
Will I be able to keep my doctors? Are they in the plan’s network?
Do doctors and providers I want to see in the future take new patients who have this plan?
If my providers are not in-network, will the plan still cover my visits?
Which specialists, hospitals, home health agencies, and skilled nursing facilities are in the plan’s network?
Access to health care
What is the service area for the plan?
Do I have any coverage for care received outside the service area?
Who can I choose as my Primary Care Provider (PCP)?
Do I need a referral from my PCP to see a specialist?
Does my doctor need to get approval from the plan to admit me to a hospital?
What costs should I expect for my coverage (premiums, deductibles, copayments)?
What is the annual maximum out-of-pocket cost?
Note: PPOs have different out-of-pocket limits for in-network and out-of-network care. If you’re considering a PPO, find out what the different out-of-pocket limits are for in-network vs. out-of-network care.
How much will I have to pay out of pocket before coverage starts. Is there a deductible?
How much is my copay for services I regularly receive, such as annual physical, routine eye exams or specialist visits?
How much will I pay if I visit an out-of-network provider or facility?
Are there higher copays for certain types of care, such as hospital stays or home health care?
Does the plan cover any additional services that Original Medicare does not?
Acupuncture or Therapeutic Massage?
Are there any rules or restrictions I should be aware of when accessing these benefits?
Does the plan cover outpatient prescription drugs?
Medicare Part A and B may cover emergency transportation.
Medicare Part B may cover medically necessary transportation ordered by a doctor.
Medicare Part A and Part B do not cover non-emergency transportation to and from your doctor’s office.
Some Medicare Advantage plans may cover trips to your doctor’s office.
Some Medicare Advantage plans also cover rides to and from your doctor’s office or fitness center.
Although Original Medicare (Medicare Part A and Part B) does not cover transportation to and from your doctor’s office, many Medicare Advantage plans (Medicare Part C) can cover non-emergency transportation.
In fact, some Medicare Advantage plans partner with ride-sharing services to provide transportation to members.
Some Medicare Advantage plans may cover non-emergency transportation.
Medicare Advantage plans provide the same benefits as Medicare Part A and Part B combined into one simple plan.
Many Medicare Advantage plans may also offer additional benefits such as coverage for prescription drugs, and some plans may also cover things like dental and vision.
In April 2018, the Centers for Medicare & Medicaid Services (CMS) announced plans to expand the list of benefits private insurance companies are allowed to cover as part of a Medicare Advantage plan.
The new expanded Medicare Advantage benefits can include things like:
Transportation to doctor’s offices
Handrails installed in the home
More coverage for home health aides
Air conditioners for people with asthma
These extra benefits are offered as part of an aim to focus on more preventive health and aging-in-place benefits.
Original Medicare and non-Emergency ambulance transportation.
Medicare Part B only covers non-emergency ambulance services to the nearest medical facility that is able to provide you with appropriate care if you have a written order from your doctor saying that it is medically necessary.
If you go to a facility that is farther away, Medicare’s coverage will be based on the charge to the closest facility, and you must pay the difference.
Original Medicare and emergency ambulance transportation.
Medicare covers emergency ambulance transportation if you’ve had a sudden medical emergency and your health is in danger.
Medicare may pay for emergency ambulance transportation by helicopter or airplane if your condition requires rapid transportation that cannot be provided on the ground.
Coverage for emergency ambulance transportation depends on the seriousness of your condition.
In some cases, Medicare may cover transportation in an ambulance if you have End-Stage Renal Disease (ESRD) and need ambulance transportation to and from the facility where you receive dialysis treatment.
Medicare transportation costs.
If your ambulance service is covered by Medicare, Medicare Part B typically covers 80 percent of the Medicare-approved amount, and you pay 20 percent (once your deductible is met).
In 2020, the Medicare Part B deductible is $198 per year.
Do Medicare Supplement plans cover transportation?
Medicare Supplement Insurance plans (also called Medigap) are sold by private insurance companies to work alongside your Original Medicare coverage.
A Medigap plan won’t typically cover transportation, but a Medigap plan can help cover the out-of-pocket Medicare costs that you may face if Medicare covers your transportation.
For example, if your ambulance ride to the hospital is covered by Medicare Part B, some types of Medicare Supplement plans will cover your Part B deductible, and all Medigap plans provide at least some coverage for your Part B coinsurance costs.
Medicare Supplement plans and Medicare Advantage plans are very different things, and you cannot have a Medigap plan and a Medicare Advantage plan at the same time.
Get more from your Medicare coverage.
To learn more about your Medicare Advantage plan options and to compare plans that cover transportation that may be available where you live, call and speak with a local licensed insurance agent today.
With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through original Medicare (Parts A and B). These programs were originally known as “Medicare Replacement” or “Part C” plans. Then as part of the Medicare Modernization Act of 2003, “Medicare Replacement” plans