Does Insurance Cover Massage Therapy?

Will Your Insurance Pay for Massage Therapy?

Insurance is one of the most complicated and frustrating, yet extremely important things to have in life. Understanding how your policy works and what kind of coverage you have isn’t always straightforward and dealing with agents can take a lot of patience.

While most basic insurance policies have you covered for accidents, procedures, and check-ups, it is always good to know if there are other things your insurance will pay for. In this article, I’ve collected information on whether insurance covers massage therapy and what you need to know about how it works.

So, does insurance cover massage therapy? There is no guarantee that your insurance policy covers massage therapy. Most health insurance policies will only cover massage therapy treatment if it is considered medically necessary by a doctor’s referral. For individuals who suffer from constant pain, massage therapy is an extremely helpful treatment that can be better for your body than painkillers and other methods. 

To find out if your insurance covers massage therapy, contact your agent; they can help you figure out what insurance will help pay for and what you can do to find an additional policy to help.

Keep reading to find out more about massage therapy and insurance.

What Is Massage Therapy?

Massage therapy is a treatment provided by a trained, certified medical professional who manipulates the soft tissue of the body using different degrees of pressure and movement. It is often used to reduce stress, lessen muscle tension, relieve chronic pain, increase relaxation, and improve immune function and response.

Many medical professionals are starting to recommend massage therapy as a treatment to help patients cope with pain, cancer, heart disease, stress, stomach issues, and more. Though it is becoming more accepted as a form of medical treatment, most insurance companies do not cover the cost of services unless it is considered “medically necessary”.

Contact Your Insurance Agent

The first thing you should do if you’re looking into massage therapy treatment is to contact your insurance representative to determine what kind of coverage you have. Some questions that would be helpful to ask the agent include:

  • How do I know if my massage therapy prescription is covered by my service plan?
  • What kind of doctor needs to prescribe massage therapy for me and what needs to be included in the prescription?
  • Are there limitations to the number of visits or length of time for each visit?
  • Does my prescription for massage therapy need to have a particular diagnosis?
  • Who can I make an appointment with that is in-network for my massage therapy prescription?

 

By asking these questions, you are more likely to find ways to get your insurance to cover any costs that may be associated with your massage therapy. If you haven’t yet gotten a diagnosis or prescription, the answers to these questions can help when you visit with your doctor to find a way that allows your insurance to take over the cost.

Massage Therapy and Your Insurance Coverage

In the past few years, what was once seen as more of a spa treatment, massage therapy has quickly become considered a reputable treatment method for pain tolerance.

As more healthcare providers recommend massage therapy as a treatment for patients, individuals are seeking benefits from their insurance providers. Unfortunately, at the current time, there is no standard coverage for massage therapy.

The reasoning behind the requested care and how that care is defined by the insurance company will determine what kind of coverage you can get. If the treatment is medically necessary and fits the criteria provided by the company, the patient can get reimbursed for the treatment.

Receiving referrals by physicians is one of the best and easiest ways to get massage therapy covered. Once you receive a physician referral, it’s important to talk with your insurance company in case you need to get pre-authorization or other documents for the services.

What If Insurance Will Not Cover Massage Therapy?

If you have talked to both your doctor and your insurance company and they have decided that you do not qualify for coverage of the treatment, there are a few other ways to get reimbursed.

  • HSA/FSA Card: flex spending accounts that you set up through your employer, where you set aside money to pay for qualified medical expenses, can help cover any cost that insurance isn’t willing to pay. (you will need to verify that the massage therapist accepts this form of payment)
  • Affiliate Insurance Company: some insurance companies allow massage therapist’s to affiliate with them, meaning that though clients won’t receive coverage for the treatment, the insurance company will work with the therapist to provide discounted rates

Communicate With Your Doctor 

Insurance can be frustrating for anyone and everyone to deal with that isn’t an insurance agent or seller, so, doctors may be willing to work with you on finding a diagnosis that will be covered by your insurance policy.

If you’ve looked into some treatments for your pain and have decided that massage therapy may be useful, communicate that with your doctor. Advocate for yourself by saying you’d like to try massage therapy and see if they will recommend it for you.

Once your doctor has agreed to prescribe massage therapy as your treatment, ask them to diagnose the problem in the most general way possible. A term like “muscle pain” will allow a massage therapist to treat you more broadly and easily.

It can also be helpful to ask that the prescription not specify the frequency or number of massages – this can allow you to receive the therapy more times without having to pay out-of-pocket.

 

Do Your Research

Research is one of the most important things to do when dealing with insurance and medical treatments. Not only do you want to find a massage therapist who is in-network with your insurance provider (if it will be covered), but you also want to be sure it is the right treatment. 

You may think massage therapy would be a great treatment for you, but be sure to take your doctor’s medical advice into account before requesting it as a treatment option.

If your insurance will not cover the therapy, or your doctor has not prescribed it for your treatment, then you’ll want to research a therapist who is not very expensive but good at what they do.

Once you have decided to pursue massage therapy without insurance coverage, you can still find a therapist who can work within your budget – you just have to do the research.

Related Questions

How Do I Find the Right Massage Therapist?

Just like you would research and ask for recommendations for a primary physician or medical specialist, you should do the same for a massage therapist. If your insurance will cover your massage therapy treatment, you can talk with them about finding a therapist that is in-network with your provider – they will likely have a list of people you can look at.

Consider what your goals are with massage therapy, determine what frequency is feasible with your schedule, and talk with the therapists before making appointments. Many medical providers are happy to consult with you before you choose to make them your health worker.

What Is the Difference Between a Registered Massage Therapist and a Massage Therapist?

Registered massage therapists have trained and studied to receive their license in massage therapy while a massage therapist does not have a license. Many different types of massage therapy will require different levels of education and practice.

Some of the more well-known massage therapy practices that are designed more for relaxation include deep tissue, acupressure, reflexology, sports, etc. 

When it comes to massage therapy that is medically focused, treatment will often be combined with chiropractic adjustments. Going to a massage therapist for a diagnosed medical condition means that your treatment will be designed specifically for your problem and you will visit regularly until the problem is fixed or pain is alleviated.

How Much Does Massage Therapy Cost – With and Without Insurance?

Depending on where you live, the average cost of massage therapy is around $60 per hour. Some licensed medical professionals such as doctors, occupational therapists, osteopaths, and chiropractors may have a massage therapist working under their supervision – in this case, you may be able to use your health insurance to cover the therapy (ask your insurance and healthcare provider about this option).