I am frequently asked this question by clients. The short answer is yes, no, maybe and it depends. I’m going to navigate the different ways that insurance can cover all or part of your massage and how it all depends upon the type of insurance.
Let’s start off with the easiest answer. YES!
I am a provider for Anthem Blue Cross/Blue Shield of Colorado and have been for over ten years. Anthem has an excellent massage therapy benefit for their members. The benefit can vary slightly with the plan but typically it is 20-24 visits per year with a co-pay. The co-pay amount can vary anywhere from $12 to $35. This is an excellent plan to incorporate massage into your wellness program, allowing members to get massage frequently and stay ahead of musculoskeletal problems that may arise.
Other plans may have co-insurance and this is the amount members pay after they have met their deductible. People that have this plan typically have an event that triggers hitting or getting close to their deductible. At that point, they begin to pay a co-insurance amount. This is typically $20 or less, dropping as they get closer to their deductible and then they pay ZERO for massage once the deductible is hit. (I don’t know the how’s and why’s of this, but this is what I have seen from Anthem) A good example of someone that might utilize this is a person that has an accident of some sort requiring surgery. Their deductible is hit and after surgery I might see the client weekly for up to 20 weeks. The treatment plan is often to manage pain initially and then to rehabilitate the injury in conjunction with physical therapy. (PT is a separate benefit within the Anthem plan)
Every year, I get busier in the final quarter as people realize they have massage therapy benefits and they try to maximize it before the end of the calendar year. If you have Anthem, you can contact me and I can verify your benefit. Sometimes it gets tricky if your parent company is out of state. Anthem has many plans across the country and typically it is the “of Colorado” plans that will garner you massage therapy. If you have Anthem, email me and I can verify your benefits.
Unfortunately, Anthem is the only health insurance company for which I am a provider. If you have a different plan I’m unable to bill that to your insurance company.
Now, let’s move on to MAYBE!
The maybe comes into play if you were involved in a motor vehicle accident (MVA). In Colorado we no longer have no-fault insurance and are in a tort system. I don’t do a lot of MVA claims but if you are already an existing client I will do my best to help you out. I contacted my insurance agent, Bill Duggan, of State Farm to help navigate some of these questions.
Auto insurance policies have a Medical Payment benefit that is included automatically with policies in Colorado. Most often, the benefit is $5,000 but some people may elect for more coverage. If you don’t have this benefit it is because you opted out at some time. I recommend that you make sure you have this rider on your coverage, it is relatively inexpensive and will pay for injuries if you are in an accident. If another party is at fault in an accident, your own policy will pay until you meet your limit then the liable party will be responsible for the rest.
If you have questions regarding your policy and Medical Pay or how it works, contact your insurance representative.
IT DEPENDS!
Many people are opting for high deductible health insurance plans these days, myself included. Typically these are people that just don’t use health insurance all that much except for annual physicals, flu shots and an occasional cold.
With a high deductible plan people are eligible for a Health Savings Account (HSA). This is a savings account where you can put money that is used specifically for health care costs that health insurance will not cover, such as massage! How it works is that you pay for your massage out of your HSA via a debit card that is provided to you by the financial institution associated with the account. HSA’s can be set up through an employer or you can set one up yourself if you are self-employed like I am.
There are tax advantages to having an HSA and I’ll leave the particulars about them to your personal bookkeeper or accountant. But if you are eligible for an HSA I would highly suggest getting one. This will pay for your massage therapy and I am able to process those payments because I am set up as a health care provider.
What I see less of these days are Flexible Spending Accounts (FSA). This is similar to an HSA except the money does not roll over at years end. You have to spend the money within the same calendar year. I process these payments the same way as HSA cards. Occasionally clients need to provide a receipt for the massage, but not very often anymore.
NO
When it comes to Medicare or Workers Comp I don’t get involved at all. It’s a road that I’m not staffed to drive on nor do I have any desire to do so.
RESEARCH IT!
It is worth your while to research and find out if insurance will help pay for massage therapy. For whatever reason, Anthem does not do a good job of informing members about the massage therapy benefit. Nearly all of the time, clients find out by accident that they have this benefit. But once they realize they do, they absolutely love it! Unfortunately many employers are switching health insurance plans frequently, so it can change from year to year. Maybe you don’t have Anthem for 2020 but that may change, so keep that in the back of your mind if your employer does change plans during open enrollment.