Medicare covers medical services and drugs approved by the Food and Drug Administration (FDA) to treat specific medical issues.Most alternative and naturopathic medicineare not FDA approved, and therefore, Medicare doesn’t cover it. However, there are some alternative medicine services that Medicare will cover, given you meet the right criteria.
Acupuncture and Medicare
Originated in China, acupuncture is a form of alternative medicine in which needles are inserted in specific areas of the body to help with pain and stress management, as well as other issues. Up until 2020, Medicare didn’t cover acupuncture for any reason. However, now Medicare will cover acupuncture visits if needed to treat chronic lower back pain.
If you have suffered from chronic back pain lasting at least twelve weeks, and an identifiable disease or condition does not cause the pain, then Medicare will cover up to twelve acupuncture visits within a 90-day period. If your doctor finds that acupuncture improves your lower back pain, then Medicare may cover eight additional visits. However, no more than twenty visits will be covered in any given year.
Another requirement that must be met for Medicare to cover your acupuncture visits is that your doctor must have a masters or doctorate in acupuncture and/or Oriental medicine. Your doctor must have obtained his or her degree from an Acupuncture and Oriental Medicine accredited school. The doctor must also have an up to date, unrestricted acupuncture licensed in the state in which he or she practices.
Chiropractic care and Medicare
Medicare does not cover most chiropractic services as Medicare doesn’t believe them to be medically necessary. However, if you have a spinal subluxation, Medicare will cover a manual manipulation of the spine by a chiropractor. A spinal subluxation is a term that describes abnormal positioning of the vertebra resulting in loss of function.
These manipulations can be done an unlimited number of times in a year as long as they are continuously coded as medically necessary to correct a spinal subluxation. Medicare does not cover other services done by a chiropractor such as x-rays and massage therapy.
Medicare costs for covered alternative medicine
If your alternative medicine service is covered, you will be subject to the Part B deductible and coinsurance. As of 2020, the Part B deductible is $198. After you have paid up to $198 out-of-pocket for Medicare Part B-approved services, Part B will cover you at 80%. You will then have a 20% coinsurance you’re responsible for when receiving Part B services.
However, most Medicare Supplement plans cover your Part B coinsurance for you in full. Therefore, if you enrolled in a Medicare Supplement plan, you likely won’t have any bill leftover to pay. On the other hand, Medicare Supplement plans that are available to new Medicare beneficiaries in 2020 don’t cover the Part B deductible, so you will at least have to pay that out-of-pocket.
Other forms of alternative medicine
As mentioned earlier, Medicare doesn’t cover most forms of alternative medicine. This includes but isn’t limited to medical marijuana, cannabidiol, and massage therapy.
Although 33 states have legalized the use of medical marijuana, Medicare does not cover it as Medicare sets federal rules and regulations. Therefore, even though states can choose to legalize this form of alternative medicine, Medicare isn’t required to cover it in those states.
Cannabidiol (CBD oil)
CBD oil is one of many cannabinoids found in cannabis plants. The FDA has approved one form of CBD oil called Epidiolex, which is said to treat the symptoms of two types of epilepsy. However, Medicare does not cover CBD oil as it is not deemed medically necessary. As well, CBD oil laws vary from state to state.
Massage therapy is used for various purposes, such as pain relief, rehab, stress reduction, relaxation, and more. Medicare does not deem massage therapy as medically necessary to treat, diagnose, or prevent a medical condition, so, therefore, it is not covered by Medicare.
While Medicare has improved its coverage guidelines to include more alternative forms of medicine, there are still many that Medicare doesn’t cover. However, Medicare is constantly updating its rules and regulations to meet the status quo, so the future may hold more alternative medicine coverage for seniors.