Insurance Question

[jlsmithseven]

Hi
I know many of you know how to get medical insurance to pay for CPAP supplies very well. I just started with AeroFLOW and got my insurance to pay for things. I have an RX from my doctor for massage therapy as it helps me function for my job/life but my insurance is saying they will not reimburse me. Have any of you had success with insurance paying for massage therapy? I've had chiropractic work in the past but it does not help me at all really. Massage helps me sleep better too. Just wondering if anyone can help? Thank you.

[ChicagoGranny]

Google this

Do health insurance companies in (name of your state) cover massage?

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BTW, Medicare does not cover massage.

[Pugsy]

Just because a doctor prescribes something doesn't mean that insurance will pay for it.
I wish it did....I want a hot tub for my arthritis and my doc would give me a RX for the hot tub.
My mom's insurance refused to pay for rehab for her recent broken femur....ordered by the orthopedic surgeon. Multiple appeals failed.
I could go on and on but won't.

If it is that important to you then you should probably try to find an insurance plan that will pay for massage therapy and make a switch if you can....and I don't know of any that consider massage therapy a covered expense.

You could try appealing....if you don't try we know they won't pay so it might be worth trying...at least be a squeaky wheel but I wouldn't go holding my breath.

[Janknitz]

Ask for a copy of your "Evidence of Coverage". A lot of plans now have this online, but you can also request one by calling your insurance company or writing them. The Evidence of Coverage (EOC) is the actual contract between you and your insurance company, even though you've never seen it unless you knew to ask for it.

The EOC spells out in detail exactly what is covered and what is not. Unless it says massage is covered, it's not. And if it is covered (some insurers actually do) it will say what the coverage criteria is.

You need to learn to be a savvy consumer. If you're on traditional Medicare you missed the open enrollment for supplemental insurance--that period ended December 7th. There's a different enrollment for Medicare Advantage plans (January 1 - March 31) and some of them do cover things like massage because they want to sign up more people since they are paid "per capita" for every person who is an Advantage plan Member, every month, whether you use the plan or not. If you are not on Medicare, it may still be open enrollment for an ACA plan or private or employer plan, so you can shop around. It's rare to have massage covered, but some plans do.