Medicare is a popular health insurance program for senior citizens here in the United States. It helps to cover medical costs and can help seniors stay healthy. But does Medicare ever pay for acupuncture? Here’s what you need to know.
Acupuncture visits in the US are covered by Medicare for people with chronic low back pain. If you improve, Medicare pays for an extra eight sessions. If your doctor determines that your chronic low back pain isn’t getting better or is becoming worse, Medicare will not cover any more treatments.
You may have seen people getting acupuncture and wondered if Medicare covers it. It depends on the circumstances. Let’s explore what Medicare does and does not cover when it comes to acupuncture. We’ll also look at some of the pros and cons of this type of treatment. So, if you’re curious about whether or not Medicare pays for acupuncture, keep reading!
The Centers for Medicare and Medicaid Services put out a press release titled CMS finalizes decision to cover Acupuncture for Chronic Low Back Pain for Medicare beneficiaries.
What Does Acupuncture Actually Do?
Acupuncture is a form of ancient Chinese medicine that involves inserting thin needles into the skin at strategic points on the body. Acupuncture is said to be beneficial for a wide range of issues, including pain, anxiety, and infertility. Some people also use it as a way to relax and de-stress. While research on the efficacy of acupuncture is ongoing, there’s some evidence that it may help improve symptoms for certain conditions. The human body is believed to contain more than 1,000 acupuncture points that can vary in number from person to person.
Research shows that acupuncture may have various positive effects on health, including relieving pain and anxiety. Some research has even indicated that acupuncture might be helpful for fertility. Still, other studies have found no significant benefit of acupuncture for any health condition. As with many forms of complementary medicine, there are few high-quality clinical trials on the use of acupuncture in children or teens. The use of acupuncture on children and adolescents is relatively rare, yet there is some evidence it may improve certain conditions. For example, one small study found that children who received acupuncture treatments showed greater improvement over time than those who didn’t receive additional treatment after their initial chiropractic care (for idiopathic scoliosis). Researchers noted, however, that poor-quality studies make it difficult to draw definitive conclusions about the benefits of acupuncture in young people.
Does Medicare Cover Low Back Pain?
The report indicates that Medicare will now cover acupuncture for Medicare patients with chronic low back pain. This is good news as Original Medicare doesn’t cover any acupuncture procedures since the inception of Medicare in 1965. You might be saying well my plan covers me for acupuncture. Now, what is you talking about Medicare is now covering acupuncture. Private Insurance companies are the administrators of Medicare Advantage plans. Medicare Advantage plans cover acupuncture. In addition, some Medicare Advantage plans do cover acupuncture procedures. This press release describes how Original Medicare will cover acupuncture in the future. Acupuncture for chronic low back pain will cover up to 12 visits in 90 days.
Chronic Low Back Pain Definition
Chronic low back pain is defined by CMS as 1) pain lasting longer than 12 weeks or longer. 2) nonspecific, in that it has no identifiable systemic cause (example not associated with metastatic, inflammatory, infectious, etc. disease) 3) not associated with surgery; and 4) not associated with pregnancy. In addition, an additional eight sessions will be covered for those patients demonstrating improvement. And no more than 20 acupuncture treatments may be administered annually. Last, treatment must be discontinued if the patient is not improving or is regressing. Centers for Medicare and Medicaid Services Full Decision Memo: https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=295 Section 1862(a)(1)(A) of the Social Security Act https://www.ssa.gov/OP_Home/ssact/title18/1862.htm
Does Medicare Cover Pregnancy and Birth?
As a side note, I get this question from time to time because of people’s curiosity. They want to know if Medicare covers pregnancy. Medicare does cover pregnancy. Most people are surprised when I tell them that because women, in general, are not getting pregnant at age 65 and older. The reason Medicare will cover a pregnancy is people under the age of 65 can be covered by Medicare because of a disability. To receive Medicare because of a disability the potential Medicare beneficiary must be disabled for 24 consecutive months. The youngest person I have personally helped get coverage for a Medicare Supplement was in her mid 30’s.
Can a Physician Do Acupuncture?
The personnel allowed to provide acupuncture services are physicians, nurse practitioners/clinical nurse specialists, and auxiliary personnel. They may furnish acupuncture procedures if they meet all applicable state requirements.
Conclusion
I know this is a short article. But the information covered I thought was very important on how Medicare will cover acupuncture in the future. If you have any questions about Medicare Acupuncture or any other questions about Medicare, in general, I am here to help. I hope you found today’s article informative and interesting to read. If you have any questions or comments please leave them below so I can respond to your feedback personally!
About The Author — Christopher Duncan
I’m Chris Duncan, owner of Trusted Benefits Direct. As your Medicare advisor, I want you to know that my business offers superior solutions for everyone. I do not work for insurance companies, which allows me to serve you at a high level without any hidden agendas or conflicts of interest. All resources are provided at no cost. Because people must find peace of mind when looking ahead years down the line.
As an insurance agent, it’s my goal to make your life easier. That includes the process of securing all types of coverage for you and your loved ones, including Medicare Supplements, Medicare Advantage, Medicare Part D, Final Expense life insurance services, and retirement security plans. You can reach me toll-free at 800-910-3382 or get a free quote on MedicareRateQuote.com with just a few clicks! Don’t forget that I also offer contact forms if you would like more information from trustedbenefitsdirect.com – click here now!
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