Massage and Insurance Companies

Massage therapy is still not covered by insurance, and this is further disadvantaging those with chronic or acute medical conditions who have already been paying for these basic medical requirements out of pocket, and are now having to suffer in silence.

We are paying hundreds of dollars a year for health and insurance coverage, many are also paying out of pocket for “alternative” medical services such as massage therapy. The problem lies in the conflicting views concerning massage therapy: is it a luxury or a physical form of medicine? 

These hard times offer some perspective: is it finally time for these insurance providers to step up?

Do You Have Coverage for Massage?

Massage therapy may be defined in several different ways by an insurance company. How it is defined and the reason for getting the massage will determine whether you will be covered by your insurance. If a “massage therapist” treatment isn’t covered in your policy, be sure and ask about these alternative options and discuss them with your doctor. 

Getting Insurance to Cover Massage

If you want your health insurance to cover massage therapy, you may have to have your massage therapy prescribed or recommended by a doctor. In a recent survey by the American Massage Therapy Association, 67% of respondents said that their physician recommended they get a massage.

How Does Coverage for Massage Work?

Once you know that your health insurance covers massage therapy, here are the important questions to ask so you understand how your policy will cover it:

• What are the conditions to qualify for reimbursement?
• Is there is a deductible, or any out-of-pocket cost to you? 
• Is there is a maximum amount payable per policy term (year)?
• Is there a maximum reimbursement per visit? For example, if the maximum per visit is $90, and you use a massage therapist who will charge $150, you will not be able to claim the full amount and will have to pay the difference.
• Is there a maximum time limit per body “region” (example, 15 minutes).
• Are there specific massage therapists you must go to?
• Do all types of massage qualify for coverage?

The Bottom Line

Health insurance may provide coverage for massages that are medically necessary or prescribed by your health management organization (HMO). But even when health insurance covers massage, there may be a limit or maximum amount payable during a policy term.

 Before getting a massage, check with your insurance company to determine if it is covered. If not covered as a “massage,” find out if there is coverage for physiotherapy, from chiropractors or other related specialists, and discuss these options with your doctor. If your physician prescribes massage therapy as part of a treatment plan, that may allow you to claim it on your health insurance. 

Good information to know. 

Nancy