Is Massage Therapy a Covered Benefit?

Massage therapy can have many medical benefits. It can relieve muscle tension, improve circulation, and help with pain relief, stress, and anxiety.

Massage therapy is a complementary and alternative medical treatment (CAM). When it comes to certain medical illnesses and situations, complementary and alternative medicine (CAM) can be used to supplement mainstream medical therapy by doctors.

23.5 percent of American adults spent money on supplementary health measures at least once in 2012, according to the Centers for Disease Control and Prevention (CDC).

Are massages covered by insurance?

Massage therapy is becoming increasingly popular as a medical treatment, and it appears that health insurance should cover massages. However, this is not the case for all policies.

For example, Medicare does not cover massage therapy, so you will likely be responsible for 100% of the cost if you seek this treatment. Even if your health insurance provides coverage, there may still be limitations.

The definition of massage therapy may vary depending on the insurer. That definition of massage, and the reason you’re getting one, will likely determine whether insurance will cover it.

If massage treatment isn’t covered in your policy, be sure to ask about alternative options. It’s also a good idea to discuss them with your doctor.

If you are eligible for services from osteopaths, chiropractors, occupational therapists, and physical therapists who also use massage techniques, these visits may be covered by your insurance.

There is no standard requirement for insurance companies to reimburse expenses for massage. Massage therapy may be covered:

When the massage is considered medically necessary and/or fits the definition and criteria of coverage given by the insurer,
If the massage fits into the criteria of a “habilitative or habilitative” treatment, it may be covered by health insurance as an essential health benefit. Talk with your doctor and your insurance company to be sure.

The best way to find out whether massage therapy is covered is by asking your insurance company directly.

How to Get Your Massage Therapy Covered

If you want your insurer to cover massage therapy, you may have to have your massage therapy prescribed or recommended by a doctor.

In a survey by the American Massage Therapy Association (AMTA), many patients reported that their doctors are looking to massage therapy as a complementary option for addressing their health concerns.

Of the patients who talked about massage therapy with their doctors,

25% were referred to a massage therapist.
24% said they were strongly recommended by their doctor to receive a massage.
23% said their doctor encouraged them to get a massage.
19% were told that a massage might benefit them.

Before booking a massage, make sure the massage provider is accepted by your insurer. Find out whether the massage must be deemed medically necessary in order to be covered. If so, ask how to meet the criteria.

Questions to Ask About Massage Therapy Coverage

If you learn that your insurer covers massage therapy, ask these questions so you will understand how your policy will cover it:

What are the conditions to qualify for reimbursement?
Is there a deductible or any out-of-pocket cost to you?
Is there a maximum amount payable per policy term or year?
Is there a maximum reimbursement per visit? For example, if the maximum per visit is $90, and you use a massage therapist who will charge $150, you will not be able to claim the full amount.
Is there a time limit per body region?
Are there specific massage therapists you must go to?
Do all types of massage qualify for coverage?

If you and your spouse each have health insurance through an employer, you may be able to make a claim under both of your insurance plans using coordination of benefits. If massage therapy were covered, you could get the maximum from both plans, thus doubling your coverage.

How Much Does Massage Therapy Coverage Cost?

Like all benefits, the more coverage a policy offers, the more it’s likely to cost. The cost will vary by insurer.

Signing up for health insurance through an employer can save you money. That’s because your employer will often pay part of the cost of the premium for you. It may also offer health insurance plans with more benefits, like massage therapy.

If the message is considered rehabilitative or medically necessary, then insurance will not cost you more. It may fall under the coverage of the Affordable Care Act’s (ACA) 10 essential health benefits.

Wh at If Your Massage Isn’t Covered?

If your massage therapy isn’t covered by your insurance, consider these options to help you find and receive affordable services:

If you have a health savings account (HSA), you may be able to use it to cover massage costs if it qualifies as medically necessary. Learn more about HSAs and flexible spending accounts (FSAs).
Contact local massage schools to see whether they offer massages at a discount.
Ask for discounts when you get your massage services.

The Bottom Line

Health insurance may provide coverage for massages that are medically necessary or prescribed by your health provider. But even when health insurance covers massage, there may be a limit or maximum amount payable during a policy term.

Before getting a massage, check with your insurer to determine whether it is covered. If it’s not covered as a massage, find out whether there is coverage for physiotherapy from chiropractors or other related specialists.

Be sure to discuss these options with your doctor. If your doctor prescribes massage therapy as part of a treatment plan, that may allow you to claim it on your insurance.

Frequently Asked Questions (FAQs)

How do you find a massage therapist who accepts your insurance?

The easiest way to find healthcare that your insurance covers are to check your insurance network and see which massage therapists are available near you.

You can also call individual providers to ask whether they accept your coverage and whether a doctor’s referral is required. Be sure you confirm that they accept your coverage before you receive services.

Why doesn’t insurance always cover massage therapy?

Massage therapy is considered an alternative treatment, and insurers often won’t cover this type of treatment outright. In many cases, a referral from a licensed medical provider will overcome this barrier.

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