Medicare does not cover acupuncture or other alternative medicine. This means that you’re responsible for 100 percent of the costs for acupuncture treatments if you have Original Medicare coverage (Medicare Part A and Part B).
While Medicare Advantage (Part C) plans don't typically cover acupuncture, some plans may cover other types of alternative therapy or pain management treatments.
If you’re seeking acupuncture to help ease pain or treat joint discomfort, you may consider physical therapy instead, which can be partially covered by Medicare Part B.
Beginning in 2018, 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 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 2109, the Medicare Part B deductible is $185 per year.
If your physical therapy 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.
Although many Medicare Advantage plans (also called Medicare Part C) provide benefits that Original Medicare does not – such as prescription drug benefits or coverage for dental or vision care – Medicare Advantage plans do not cover acupuncture.
Some Medicare Advantage plans, however, 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 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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