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Does Medicare Cover Acupuncture?

"Does Medicare Cover Acupuncture?" text over image of acupuncture needles

Does Medicare cover acupuncture or other holistic treatments? Our licensed agents can help you find Medicare coverage that does. Give us a call today at (800) 950-0608 to discover your coverage options.

Just the Essentials:

  • Up until recently, acupuncture treatments were not covered by Medicare.

  • Medicare now covers acupuncture, but the coverage is limited.

  • Medicare Advantage plans may offer expanded coverage for acupuncture and other holistic treatments.

Alternative Holistic Treatments Can Help Alleviate Pain

Chronic pain is an everyday reality for most senior citizens. Traditional pain medications can help ease that pain, but most pain medications can cause bigger issues, such as addiction. Because of those issues, most seniors are seeking alternate ways to help them manage chronic pain.

Alternative holistic treatments have become a popular option for seniors who are looking for different ways to manage chronic pain. Holistic medicine differs from traditional Western medicine in that it seeks to treat the cause, not the symptoms, of pain or illness. While holistic medicine may use prescription medications as part of treatment, it does so sparingly, and focuses primarily on the use of natural remedies and lifestyle changes to help you maintain good physical and mental health.

One of the most popular holistic treatments utilized by seniors for pain is acupuncture. If you’re unfamiliar with this treatment, you may have several questions, including:

  • What is acupuncture?
  • How can acupuncture help me?
  • What are some common acupuncture benefits?
  • Does Medicare cover acupuncture?

Today, we’ll help you find the answers to those questions.

Acupuncture: A Quick Primer

As Americans become more aware of the potential issues that surround prolonged use of prescription medications for pain, alternative treatments have seen a surge in popularity over the past few decades. One of the most popular alternative treatments is an ancient Eastern medical practice known as acupuncture.

While acupuncture is new to most Americans, it’s actually been in practice for over 2,500 years. The method was invented by the Chinese to stimulate specific points on the body to rebalance energy flow.

How does the method rebalance energy flow, you might ask?

By sticking thin little needles into the skin.

“Wait, they treat me by poking me with needles?” You may be asking right now. “Won’t that hurt me just as bad, if not more, than the pain itself? How is that effective?” Believe it or not, the process isn’t as painful as you think, and as the Centers for Medicare and Medicaid Services (CMS) would discover, the benefits are more plentiful than they seem.

Attitudes Toward Acupuncture Changed in the Face of a Rising Opioid Crisis

For the longest time, CMS viewed acupuncture as a sort of placebo treatment. Following the lead of American medical researchers, they saw no real benefit to acupuncture, and the treatment was primarily seen as a fad that created the illusion of a miracle cure for patients seeking fast, easy pain relief. As the 20th century came to an end, that attitude would slightly change.

Well, for much of the healthcare industry, at least.

In 1997, the National Institutes of Health (NIH) conducted studies that showed acupuncture to be an effective treatment for not only chronic pain, but symptoms of other illnesses, diseases, and treatments as well. For example, it was viewed as highly effective for easing nausea in chemotherapy patients. Despite this research, CMS would not move from their position on the treatment, continuing to view it as ineffective and not medically necessary.

That is, until the issue of the opioid crisis would force CMS to budge. For decades, opioid medications were the primary go-to in Western medicine for pain relief. Despite research that proved opioids to be rather ineffective in treating chronic pain, many doctors continued prescribing these medications. As opioid use grew, so did the epidemic of opioid addiction.

Research by CMS in 2016 showed that one-third of Medicare beneficiaries received at least one opioid prescription through Part D coverage. Further, one out of every 10 beneficiaries were being prescribed opioids on a regular basis. These statistics sounded an alarm with CMS, and in January 2020, they finally came around to covering acupuncture for chronic lower back pain as an alternative to opioids.

Yes, Medicare Now Covers Acupuncture - But There are Limitations

If you’re seeking alternative treatments for chronic pain, and you’ve been interested in acupuncture, it is now covered by Medicare. This means that you can finally take advantage of great acupuncture benefits! However, much like Medicare’s coverage of other naturopathic medicines and treatments, coverage for acupuncture is very limited.

Let’s say you’re diabetic and you suffer from neuropathy in your hands. Does Medicare cover acupuncture for neuropathy? At this time, unfortunately not. Medicare only currently covers acupuncture as a treatment for those who suffer from chronic lower back pain. Even then, the scope of coverage is limited. When it comes to acupuncture, Medicare Part B will cover:

  • Up to 12 acupuncture sessions in 90 days.
  • 8 additional acupuncture sessions if you show improvement.
  • A maximum of 20 acupuncture sessions in 12 months.

Additionally, Medicare will only cover acupuncture if the person administering your treatment is:

  • A doctor, physician’s assistant, or nurse practitioner.
  • A healthcare professional with master’s or doctorate-level training in acupuncture.
  • A healthcare professional with a state license to practice acupuncture.

What if your condition isn’t improving, though? Your doctor may recommend additional acupuncture sessions as a part of continued treatment. Will Medicare cover those? Unfortunately, Medicare will not cover those additional sessions.

I Can’t Afford Extra Acupuncture Sessions - How Can I Find Help?

So, does Medicare cover acupuncture? Technically, yes, but again, that coverage is very limited. Much like Medicare’s coverage of other holistic treatments, there are certain requirements that must be met before Medicare will cover acupuncture sessions. However, if you’ve used up your 20 sessions in a calendar year and Original Medicare will no longer cover needed acupuncture sessions, you may still be able to find help covering the cost.

Depending on your area and provider, a Medicare Advantage plan may offer expanded coverage for acupuncture. Wondering how to find Medicare plans in your area that cover acupuncture? Start your journey by entering your zip code into our free plan finder below to discover Medicare plans in your area that may offer expanded acupuncture coverage. If you have any questions, please feel free to give our licensed insurance agents a call. They’re always happy to help!

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