Does Insurance Cover Massage Therapy?

Introduction

You may have wondered how a massage differs from one given in a spa vs. one given in a hospital or clinic, along with the cost of medical massage. Today, let’s discuss the cost of massages prescribed by a doctor as opposed to those at a spa, as they may be covered by insurance. Massage, while costly, can improve your health and well-being, especially if insurance helps to cover the bill! 

How much does medical massage cost with insurance?

Medical massage therapy (also called myotherapy) costs about $100-150 per hour on average in the United States. However, this varies substantially by region (urban regions are often more expensive due to greater operational costs), environment (fitness facilities are sometimes less expensive because massage is a means to attract members), and therapist training. In addition, therapists may provide a discounted package cost to encourage repeat visits and help them establish a practice.

If you have insurance, you should only pay a copay or pay upfront and wait for reimbursement. Furthermore, some doctor’s offices have a massage therapist working on staff, which may allow insurance benefits to go further as they are under the care of a professional’s supervision. If you are in a car accident or dealing with workman’s compensation, you may be able to get car insurance to cover massage therapy prescribed by a doctor. 

It’s possible that your massage therapist will be able to charge your health insurance directly. In other circumstances, you may be required to pay the therapist directly and then submit your own claim with an invoice for services done, which you will be paid later. You will have to pay at the time of service if your insurance does not cover massage therapy.

In some cases, you can use HSA or FSA to cover the cost of massage therapy. First, you’ll need to schedule an appointment with a massage therapy provider. Because the funds in your FSA plan expire at the end of the year, make sure you make use of them while you still can. With FSA or HSA, you can save large amounts of out-of-pocket expenses, especially if you set a massage membership.

Call your insurance company to determine what benefits you qualify for before scheduling to avoid unnecessary expenses. Some insurance companies may require a doctor’s referral. Also, it’s best to find out the copay before you schedule an appointment so you can plan accordingly. 

Finally, insurance companies make insurance claims for therapists quite difficult with a lot of paperwork, and they may not pay them for months afterward or even pay the full amount. Check with the therapist you plan to visit to see if they are willing to work with insurance companies for massage purposes. They often need to fill out paperwork long than your appointment time trying to receive payment. 

Massage covered by insurance: Is massage therapy covered by insurance?

Massage therapy is a supplementary and alternative medical treatment (CAM). When it comes to certain medical illnesses and situations, complementary and alternative medicine (CAM) can be utilized to supplement mainstream medical therapy by doctors. As a complementary treatment, not all insurances cover massage therapy. Medicare does not include massage therapy under their health insurance, nor does Tricare. 

You are more likely to get coverage from private or work-sponsored health insurance. Private insurance may have upgraded plans that include massage. Some insurance companies that cover medically prescribed massage include BlueCross/Blue Shield, United Health Care, Cigna, and Aetna. Make sure your specific policy includes massage though before scheduling an appointment. 

If your insurance does not cover massage therapy, you can ask your insurance what alternative options they do cover to help with your conditions. However, keep in mind insurance companies do not have standard requirements they must meet, but they may cover it if it’s considered medically necessary by a doctor or meets their specific criteria. Furthermore, you may have a maximum amount payable policy and only have to pay up to that amount per year. 

Does Cigna cover massage therapy?

Whether Cigna covers massage therapy depends on your specific plan and the reasons for seeking the treatment. Generally, massage therapy might be covered under Cigna if it is deemed medically necessary as part of a treatment plan prescribed by a healthcare provider. Here are some typical situations where coverage might be available:

1. Medically Necessary Treatment: If a doctor prescribes massage therapy as part of a rehabilitation or pain management program for conditions like musculoskeletal injuries, chronic pain, or post-surgery recovery, it may be covered. In these cases, massage therapy is often categorized as physical therapy or alternative care.

2. Plan Type: Some Cigna plans may offer coverage for massage therapy as part of complementary or alternative care services, while others may not include it or may require additional riders or supplementary coverage.

3. Network Providers: Coverage may only apply if the massage therapy is performed by a licensed provider within Cigna’s network. Seeing an out-of-network provider may result in higher out-of-pocket costs or no coverage.

4. Limitations and Caps: Even if covered, there may be limitations, such as the number of sessions allowed per year, co-pays, or a requirement for pre-authorization.

It’s best to review your individual plan details or contact Cigna directly to confirm whether your specific plan covers massage therapy and under what conditions.

Is massage therapy expensive?

The more coverage a policy provides, the more it will cost, just like any other benefit. The price will differ depending on the insurer. On average, medical massages range from $100-$150 which are quite similar to non-medical massage. Keep in mind, this is an estimate as the price can change due to many factors including, provider, location, and type of massage. 

Most massages are 30 minutes, 60 minutes, or 90 minutes long on average. Medical massages tend to take longer sessions due to their complexity. To further understand each client’s medical condition, a massage therapist will need to sit down with them. The cost will change according to the time and even the level of the masseuse. 

If you plan on going to many sessions, see if your medical massage therapist will give you a discount if you pay for a certain amount of sessions in advance. Other massage therapists will give you a discount if you return for your second appointment within a certain number of weeks. In addition, going to a therapist’s office rather than having them come to your home is generally less expensive.

Nowadays, massage comes with licensing for the therapist, and this brings additional costs for the therapists, which in turn raises the cost for you. They must maintain malpractice insurance, complete continuing education courses, file taxes, and pay license costs. While expensive, it’s no more expensive than for a massage in a spa but may be covered by insurance, which makes it more affordable. 

Lastly, tipping is not normal in a medical setting, so you may not need to tip; however, therapists may have slightly higher prices to compensate. Massage falls into the “it depends” category regarding tipping. It is entirely dependent on the situation and the expectations or policies established by the therapist or the facility where the massage is given.

Tipping is almost never seen in a medical environment. Therefore, you should not expect to tip if you undergo massage therapy in a medical setting. Aside from that, most massage therapy establishments encourage tipping. Gratuities are an important part of many employers’ remuneration packages for their therapists. Check at the front desk to find out the tipping policy for a specific clinic or even check their website to see if they expect or accept tips. 

When does insurance not cover massage therapy?

Medical companies cover medical procedures and will not cover luxuries such as massage that is not prescribed by a doctor. If you do not have a medical need for massage therapy and are only seeing a massage for enjoyment, then you will not be covered by medical insurance. Talk to your doctor as you will need a referral or prescription, and they may be able to work with you. Next, make sure the doctor does not put a limit on the number of massages as this will limit coverage by insurance too. 

What does Medicare cover for massage?

Medicare does not cover medical-massage. If you have Medicare, you will be responsible for 100 percent of the services. Because Medicare considers massage an alternative treatment, it’s not covered by either Medicare policies, including parts A and B. However, Medicare Part B does cover some forms of therapy, including physical therapy and even acupuncture for specific conditions. 

In addition, Medicare offers Part C plans that might cover some of the costs of massage therapy. You will need orders from your physician to receive this coverage. Massage therapy is classified as an “alternative treatment” by Medicare, meaning it is not considered medically required. That’s why massage treatment sessions aren’t covered by Medicare Parts A and B.

What does massage therapy include?

Massage therapy includes what is necessary to help you with your specific needs. Depending on the reason for the massage, the type of massage therapy will change. However, massage therapy can include soft tissue, remedial, and therapeutic massage. Also, it can include lymphatic drainage, aromatherapy, reflexology, sports massage, and other forms of massage too. 

When should you get massage therapy treatment?

Your doctor can prescribe massage for many conditions, and for many of those reasons, insurance will cover a portion of the bill. Some of the conditions include stress-related insomnia, headaches, anxiety, digestive disorders, soft tissue sprains, sports injuries, fibromyalgia, paresthesias, myofascial pain syndrome, nerve pain, and TMJ (temporomandibular joint pain).

Why Choose Portland Wellness Care for massage therapy?

Customers at Portland Wellness Care benefit from various approaches to improve their quality of life. At our facility, you will receive a personalized physical therapy treatment plan from a team of therapists that are eager to assist you in your recovery, including massage therapy. In addition, we can help you locate the correct treatments to help you feel better and recover from injuries with various additional pain management and therapies. To begin your rehabilitation journey, call Portland Wellness Care now and make an appointment with one of our physical therapists or massage therapists.

Conclusion

Massage therapy can be costly, but your insurance company may help to cover the costs. Additionally, you may be able to use FSA or HSA to cover the cost of medical massage. Either way, you will need a prescription from your primary care doctor for insurance even to consider helping with the costly treatments. Portland Wellness Care offers medical massage in clinic and works with multiple insurances. Call today to schedule an appointment.