Some Medicare Advantage plans may cover massage therapy, but specific coverage will depend on the plan.
Medicare Advantage plans do cover other medically necessary therapy services, such as physical therapy and occupational therapy.
Original Medicare (Part A and Part B) only pays for therapy services that are considered medically necessary.
If a therapy service is considered medically necessary, Medicare Part B typically pays 80 percent of the cost for the service and you pay 20 percent (after you pay your Part B deductible). In 2019, the Part B deductible is $185 per year.
If your therapy service is not medically necessary, your therapy provider must give you a written notice called an Advance Beneficiary Notice of Noncoverage (ABN) before providing the service.
The ABN enables you to choose whether you want the therapy service. If you choose to get a service that is not medically necessary, you are responsible for 100 percent of the costs.
Medicare Advantage plans (Medicare Part C) are sold by private insurers as an alternative to Original Medicare. While massage therapy is not typically covered by Medicare Advantage plans, some plans may offer it as a benefit.
In 2019, the Centers for Medicare and Medicaid Services (CMS) wrote a letter to all Medicare Advantage programs that included an encouragement for Medicare Advantage plans to offer therapeutic massage as a benefit in their 2020 plans.1
Every Medicare Advantage plan must provide at least the same hospital and medical benefits as Medicare Part A and Part B, and many Medicare Advantage plans provide additional benefits such as:
Medicare Advantage plan benefits can vary widely from plan to plan, but it may be possible to find a plan that helps cover massage therapy or other therapy services not covered by Original Medicare.
A licensed insurance agent can help you compare plans and get you enrolled in one that provides the benefits that are most important to you.
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1 AMTA. CMS Encourages Medicare Advantage Plans to Cover Massage in 2020. (Feb. 5, 2019). Retrieved from www.amtamassage.org/articles/1/News/detail/3917/cms-encourages-medicare-advantage-plans-to-cover-massage-in-2020.
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