While the insurance industry, and especially the Medicare program, continues to expand benefits, there remains a lot of opportunity for improvement surrounding alternative medicine coverage.
What is Alternative Medicine?
Alternative medicine is an umbrella term for medical practices or theories that fall outside the generally accepted Western traditional medicine.
When used with traditional medicine, alternative medicine is sometimes referred to as complementary medicine.
Medicare and Alternative Medicine
As of 2020, over 62 million US citizens (nearly 19 percent of the population) rely on some form of Medicare to help cover their healthcare needs.
The primary rule of Original Medicare (government-funded Parts A & B) is that if a treatment or service is medically necessary it is covered; however, very few alternative medicine services meet this requirement by Medicare’s standards.
For example, Chiropractic care is one of the most commonly requested alternative medicine services amongst our Medicare insurance clients.
However, while Original Medicare Part B does pay for manual manipulation of the spine when deemed medically necessary to correct a subluxation, it does not cover other services or tests a chiropractor might order, such as acupuncture, massage therapy or X-rays.
Massage therapy, another widely requested service, has been shown to ease joint and muscle pain and can reduce the increased levels of stress that tend to come with aging.
However, Medicare categorizes massage therapy as an “alternative treatment” not deemed medically necessary, and so it is not covered by Original Medicare Parts A and B.
Room for Improvement Calls for Close Examination
There are currently 1.4 million Americans living in nursing homes at an average cost of $48,000 per year.
Meanwhile, every day, 10,000 members of the Baby Boom Generation celebrate their 65th birthday (the age at which one becomes Medicare eligible.)
Taking advantage of these opportunities will help ensure aging adults have the ability to receive not only treatment but also preventive measures that will help keep them healthy and out of nursing homes longer, saving insurers money in the long-run.