Does blue cross blue shield insurance cover massage therapy

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 considered a part of complementary and alternative medicines (CAM). CAM can be used to complement standard medical treatment by doctors when addressing certain medical conditions and situations. According to the Centers for Disease Control and Prevention (CDC), 23.5% of American adults spent money on complementary health measures at least once in 2012.

Learn about massage therapy insurance coverage and how to find out whether your provider covers it.

Are Massages Covered by Insurance?

With many people turning to massage therapy as a medical treatment, it seems that health insurance should cover massages. However, not all policies do.

For example, Medicare does not cover massage therapy, so you will likely be responsible for 100% of the costs 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. 

Note

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 habilitation” 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 is a deductible or any out-of-pocket cost to you? 
• Is there is a maximum amount payable per policy term/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?

Tip

If you and your spouse each have health insurance through an employer, you may be able to claim under both of your insurance plans using coordination of benefits. If massage therapy would be 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 the 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 massage is considered rehabilitative or is 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.

What 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 where 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 is 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 these types of treatment outright. In many cases, a referral from a licensed medical provider will overcome this barrier.

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