Medicare does cover acupuncture for the treatment of chronic lower back pain. This means that you may be able to get some coverage for acupuncture treatments if you have Original Medicare coverage (Medicare Part A and Part B).
Medicare Advantage (Part C) plans will also cover acupuncture for lower back pain treatment, and some plans may cover other types of alternative therapy or pain management treatments.
Most Medicare Advantage plans also offer Medicare prescription drug coverage.
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Medicare Part B (medical insurance) will cover acupuncture for up to 12 sessions in 90 days, with an additional 8 sessions for beneficiaries who show improvement in their chronic lower back pain.
Medicare Part B can also help cover physical therapy.
Medicare no longer caps how much it will pay for physical therapy services in a single year, as long as your therapy services are deemed medically necessary by your therapy provider.
If your physical therapy or acupuncture is covered, Medicare Part B typically pays 80 percent of the Medicare approved amount, and you pay 20 percent after your Part B deductible is met. In 2022, the Medicare Part B deductible is $233 per year.
If your physical therapy or acupuncture is not deemed medically necessary by your therapist, Medicare will not cover the services, and you will be responsible for 100% of the costs.
Your therapist must give you written notice before providing services that are not medically necessary. From there, you can choose whether or not to accept the services and pay for them 100% out of pocket.
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Medicare Advantage plans cover the same benefits that are offered by Original Medicare, includes acupuncture treatment for beneficiaries who are suffering from chronic lower back pain.
Some Medicare Advantage plans may provide coverage for other types of alternative medicine. Check directly with your plan carrier to find out what forms of therapy may be covered by your plan.
If your physical therapy or acupuncture is covered by Medicare Part B, it should also be covered by a Medicare Advantage plan. If you’re enrolled in a Medicare Advantage plan, speak with your insurance company about how your plan will cover your physical therapy.
If you’d like to learn more about Medicare Advantage and compare Medicare Advantage plans that may be available in your area, call today to speak with a licensed agent.
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Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.