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Does Medicare cover acupuncture? What about naturopathic doctors? More and more these days, we get calls from Medicare beneficiaries asking whether Medicare covers acupuncture or holistic medicine. As technology advances, so does our understanding of natural medicines, and many baby boomers aging into Medicare today want to have naturopathic options.
But what does Medicare cover? Learn more in this post.
Naturopathic medicine is the practice of using therapeutic methods to both treat and prevent health issues. Many think of naturopathic medicine to be a philosophy of life. Naturopathic physicians believe that healing power comes from within one’s body rather than prescription drugs.
Many people consider the founder of naturopathy to be Dr. Benedict Lust. Dr. Lust brought over practices from Germany to America in 1892. In 1902, Lust began the American School of Naturopathy.
Naturopathic physicians follow six main principles in practice. These principles are:
People see their naturopathic practitioners for all sorts of things these days, including treating pain, hormone balancing, and getting better sleep. Naturopathic practice includes many techniques. All of which naturopathic physicians put their six principles into action. However, one technique has been around for 2,500 years and has become a desired therapy by naturopathic physicians. This technique is acupuncture.
The Mayo Clinic defines acupuncture as a key component of traditional Chines medicine in which needles are inserted throughout the body. The purpose of acupuncture is to promote natural healing. However, the most common use of acupuncture is to relieve pain.
As you age, pain throughout the body is inevitable. Baby Boomers are increasingly turning to acupuncture for pain relief in recent years.
Many naturopathic physicians treat issues such as carpal tunnel, arthritis, back pain, fibromyalgia, and sciatica with acupuncture. Though, before you rush to schedule your first acupuncture treatment, you should know whether Medicare covers it.
The primary rule of Original Medicare is that if a treatment or service is medically necessary, it is covered. Up until 2020, acupuncture (or any naturopathic medicine for that matter) was not considered medically necessary by Original Medicare.
However, on January 21, 2020, the Centers for Medicare and Medicaid Services finalized the decision to cover acupuncture. Medicare now covers acupuncture to treat chronic lower back pain. Medicare has made this decision in hopes of helping fight the opioid use epidemic by allowing beneficiaries an alternative method of pain management.
According to Medicare, chronic lower back pain is described as pain lasting at least 12 weeks and caused by a non-identifiable condition or disease. If you qualify for Medicare-approved acupuncture, you can receive up to 12 sessions within a 3-month window. After 12 sessions, if you are showing improvement, Medicare may cover an additional eight sessions. Once you receive a total of 20 sessions, you are maxed out for the year. Medicare may cover additional sessions in the following year.
If Medicare covers your acupuncture treatment and you have a Medicare Supplement plan, you will pay little to no out-of-pocket costs. For example, if you have a Medigap Plan G, Medicare will cover your sessions minus your Part B deductible and coinsurance. Your Plan G will pick up your Part B coinsurance in full, and you will only be left with your Part B deductible.
Some Medicare Advantage plans cover acupuncture. Medicare Advantage plans are an alternative to Original Medicare. The plan takes your Part A and Part B of Original Medicare and combines it with other benefits such as dental, vision, and hearing. Medicare Advantage plans must cover acupuncture just like Original Medicare does. However, they may cover the treatment in other circumstances as well.
It is important to note that each Advantage plan is different, so you will need to look up the benefits for your specific plan. In some areas of the country where holistic medicine is more commonly practiced, like California, you may find more Advantage plans which offer more integrative benefits like acupuncture.
Many people who have tried acupuncture or naturopathic care also ask us whether Medicare covers chiropractic care. Medicare Part B covers some chiropractic care when deemed medically necessary.
When it comes to your visits to the chiropractor, Medicare will specifically cover subluxation of the spine. Subluxation is a medical condition where one or more of the bones in your back or neck become out of position. This can cause discomfort or headaches as well as stiffness and inflexibility.
Seeing a Medicare chiropractor who can adjust your spine may provide relief. Just be aware that since Medicare covers chiropractic subluxation only, it will not cover x-rays or massage therapy provided by a chiropractor or someone in their clinic.
As with all Part B services, Medicare will pay 80% of the cost of your adjustments and may only cover a certain number of visits for this service. People with Medicare Advantage plans should check their plan documents for information on how their Medicare plan covers chiropractic care.
While over 30 states now allow residents to use marijuana for medicinal purposes, Medicare does not cover this use. The Food and Drug Administration has not yet approved marijuana for medical use, and the federal government still considers it a Schedule I controlled substance. This means it has no accepted medical use, and perhaps more importantly, it has a high potential for abuse. For this reason, Medicare is unlikely to cover marijuana unless that changes.
However, some Medicare Advantage or Part D drug plans may cover other cannabinoids. Dronabinol is a form of cannabis that can be prescribed to combat weight loss or loss of appetite when dealing with illness. It can also treat nausea or vomiting associated with some cancer treatments. Since the FDA approves these medications, you can check your plan’s drug formulary to see if they are included.
Cannabidiol oil or CBD has become a more common use for pain relief in recent years. It has been legalized in many states, and it can be consumed in a variety of ways: ingestion, inhalation, or application directly to the skin.
Just like medical marijuana, CBD oil is not yet covered by Medicare.
In conclusion, there is room for the Medicare coverage status to change. Studies show that a growing number of seniors prefer naturopathic medicine.
Does Medicare cover acupuncture or holistic medicine? Find out in this post.
The Huffington Post reported that 55% of older Americans would consider seeking care from a naturopathic provider. The American Association of Nurse Practitioners even launched a pilot project at the DC Federal Legislative Initiative that would show the benefits of naturopathic medicine for seniors.
Mainly, the AANP is pushing for the senior population to rely less on prescription drugs. Naturopathic physicians truly believe that they are more fit to manage patients’ prescriptions. There are much higher rates of over-prescribing from non-naturopathic doctors with their senior patients. Over-prescribing can lead to dangerous drug interactions, bad side effects, and even drug addiction in seniors.
The naturopathy community is working to be recognized in all U.S. states. As of 2020, only twenty states offer licensure and registration for naturopathic physicians. However, a few states have bills pending to allow licensing to naturopathic physicians.
As regulations change, Medicare beneficiaries may be able to receive better coverage options for treatments such as acupuncture. So if you find a new plan in the future that offers holistic benefits that you want, you might be able to change to that Medicare plan during an upcoming annual election period.
