Does Your Medicare Plan Cover Acupuncture?

By: Agnus Smith
Published: Thursday, September 13 2018
Last Updated: 5 years ago

Medicare provides great health coverage for all Americans over the age of 65. The coverage is generally comprehensive and covers many of the most important health issues that may be affecting you. However, when it comes to alternative forms of medicine, such as holistic practices, you may need to look elsewhere for coverage or find yourself footing the bill.

For instance, Medicare will not cover your general vision or dental needs. While this is common for most insurance plans, it does come as a surprise to some Medicare beneficiaries. There is also the question of coverage for alternative medicines. The most common form of alternative medicine found in the United States is the ancient Chinese practice of acupuncture. Acupuncture is a form of traditional medicine that Americans are increasingly turning to for wellness and stress management.

The practice involves placing small needles into your skin at certain, specific pressure points. Acupuncture is painless and has been shown to have a positive effect on your muscles and nerves and can provide a whole host of other physical benefits, including improved cognitive and mental abilities. These proven medical benefits occur alongside many of the spiritual benefits the Chinese have long associated with the practice. So, does Medicare cover acupuncture?

Does Medicare Cover Acupuncture?

Unfortunately, if you are looking for alternative medicine to deal with any health conditions, Medicare acupuncture coverage is not included in the Original Medicare plans. The Centers for Medicare & Medicaid Services (CMS) provide Parts A and B, and do not include acupuncture under Medicare Part A for hospital services or Part B for general medical services.

Why Not?

If you are seeking Acupuncture coverage under Medicare then you will be responsible for 100% of the costs of the treatment. While some Medicare beneficiaries and healthcare providers are pushing back at the CMS guidelines on Medicare acupuncture, alternative medicines are not, for the time being, a covered benefit. Medicare is currently designed to prevent and/or treat life-threatening conditions, and while acupuncture does treat conditions that affect your quality of life, these are not normally life-threatening issues.

Do Any Medicare Supplement Plans Pay Acupuncture?

Medicare Supplement plans, known as Medigap coverage, are not allowed to cover anything that traditional Medicare does not cover, per current CMS guidelines. Due to those constraints, Medicare Supplemental plans cannot cover any forms of alternative medicine including acupuncture. These plans simply fill in payment gaps for already covered services.

What About Medicare Advantage Plans?

You may be wondering then does Medicare cover acupuncture under Medicare Advantage plans? Advantage plans, sometimes called Medicare Part C, are private plans that replace your Medicare Part A and B coverage. These plans are provided by commercial insurance providers, with funding from CMS. This allows the plans to offer additional benefits, on top of those already provided by Original Medicare.

Acupuncture coverage under Medicare Advantage plans is, therefore, a possibility. Some Advantage plans do cover these services, though you may be limited to certain providers and treatment plans within a network or region.

How Much Acupuncture Will Cost You Out-Of-Pocket

The average visit to an acupuncture specialist for a single treatment can cost upwards of $100 or more. This can vary from provider to provider but in most scenarios, these alternative treatment costs can add up quickly. This is particularly true of acupuncture, where an ongoing course of sessions is usually advised for the treatment to be effective.

Finding Coverage For Acupuncture

Not every Medicare insurance company will offer plans that include acupuncture, but an experienced agent will be able to point you in the right direction, and FirstQuote Medicare can help. By entering your zip code, you can not only compare Medicare Supplement quotes, but you can talk to experienced agents. Find the coverage you want, and enroll today.