Have you ever wondered how to claim massage through health insurance? Massage therapy can provide real health benefits, but the out-of-pocket cost can be prohibitive for many people.
In this article, we’ll walk you through how to claim massage through health insurance by your plan. We’ll look at the types of plans that sometimes include massage coverage, give tips for submitting claims and dealing with denials or reimbursements, and help you understand any limits or exceptions. With the right approach, you may be able to reduce or eliminate the cost of therapeutic massage through your insurance provider.
Getting a massage for health reasons doesn’t have to break the bank if you learn how to work within your plan’s rules.
Is Massage Therapy Covered by Health Insurance?
Many health insurance plans offer coverage for massage therapy, especially if it’s prescribed as part of a treatment plan. The coverage and limits can vary between insurance providers and specific plans. Check with your insurance provider to see if they cover massage and for how much.
- Chiropractic plans often provide the best coverage for massage since it’s frequently used in conjunction with chiropractic adjustments and other treatments. They may cover a certain number of massages per month or year.
- If massage is prescribed by a doctor as a treatment for a medical condition like back pain, neck strain, or fibromyalgia, many standard health plans will provide at least partial coverage.
- Some insurance plans provide coverage for massage as part of a wellness program. They may cover a certain number of massages each year to promote health and prevent injury. Check if your plan includes wellness benefits.
Massage therapy can be so valuable for both prevention and rehabilitation that it’s worth the effort to get at least part of the cost covered.
How To Claim Massage Through Health Insurance
Many health insurance plans cover massage therapy, especially if given by a licensed massage therapist. To claim a massage through your insurance, there are a few steps to follow:
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Check Your Coverage
First, verify that your specific health insurance plan covers massage therapy. Call the member services number on the back of your insurance card and ask about your coverage for massage, including any limits on the number of visits or coverage amount. Some plans may require a doctor’s referral or prescription to cover massage.
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Find a massage therapist who accepts insurance
Search online or call local massage therapists to find the ones who accept your insurance. Ask if they are an “in-network” provider for your insurance plan. In-network means they have a contract with your insurance company to provide services at a discounted rate. See if you need a referral or prescription from your doctor for the massage to be covered.
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Schedule your massage appointment
Call to schedule a massage appointment with a therapist who accepts your insurance. Let them know you want to use your insurance coverage for the visit. Ask what information or forms they will need from you to bill your insurance. This usually includes your insurance details, member ID, and possibly a doctor’s referral.
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Pay your copay and coinsurance
Most insurance plans require a copay, coinsurance, or both for massage therapy. This is the amount you pay out of pocket for each visit. Pay this amount at the time of your massage. Your massage therapist will then bill your insurance for the remaining amount.
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Follow up on the claim
After your massage, follow up with your insurance provider to make sure the claim for your massage was processed properly. Check that the billing from your massage therapist matches the coverage details you received from your insurance company. Watch for reimbursement checks in the mail or see the claim appear in your online insurance portal.
With the right plan and a few extra steps, you can get therapeutic massages covered. Relieving stress and tension has never felt so good!
Requirements to Get Massage Therapy Covered
To get your health insurance plan to cover massage therapy, there are a few requirements you’ll need to meet. Many insurance companies will cover massage only if it’s deemed medically necessary by your doctor. Some may require a prescription or referral from your physician stating that massage therapy will help treat a diagnosed condition.
Medical Necessity
For insurance to cover massage therapy, it typically must be to treat an injury or illness. Conditions like chronic pain, fibromyalgia, arthritis, or muscle strains are often approved. If you’re seeking massage for general wellness or relaxation, your insurance likely won’t cover it. Talk to your doctor about how massage could help improve your health issues or pain. Have them provide a letter of medical necessity explaining how treatment will aid in your recovery or mobility.
Licensed Massage Therapist
You’ll need to visit a licensed massage therapist for insurance to apply. Check with your insurance provider for a list of approved therapists in your area. The therapist must also accept your specific insurance and any pre-authorization needed. They will bill your insurance directly. You may be responsible for any copays or coinsurance at the time of your appointment.
Pre-Authorization
Some insurance plans require pre-authorization or pre-certification before covering massage therapy. This means your doctor will need to submit a request to the insurance company for approval of a specific number of therapy sessions. The insurance company will review and determine if they deem it medically necessary based on your condition. It’s best to check with your insurance provider to see if pre-auth is needed and have your doctor start the process.
Conclusion
So there you have it on how to claim massage through health insurance. This may involve some effort, but with a bit of persistence and know-how, it’s an achievable goal for many. At the end of the day, taking care of your body should be a priority – your future self will thank you.
