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You are here: Home / Getting Massage Covered by Health Insurance

Getting Massage Covered by Health Insurance

Massage therapy could be covered by your health insurance if more people, legislators, massage therapists and massage therapy associations called for it. Health insurance policies usually do not cover things that are considered to be palliative but will cover things that are deemed to be medically necessary. Each carrier will have their own definition of medical necessity. For massage therapy, there usually has to be a loss of function AND pain to be considered medically necessary. Prevenative care for stress, coverage of massage for depression/anxiety are usually not covered.

As a consumer of massage therapy, you most likely know there is a variety of massage therapists and that massage therapy can help you with pain, injuries and various conditions when done in the right environment by the right massage therapist. Not all massage therapists are the same. There are also hundreds of types of massage which makes it difficult to know what to choose to help you with specific conditions.

Clinical Massage therapists or sometimes referred to as Medical Massage therapists, work with various medical conditions such as pain, muscle injuries and conditions as well as things like PTSD and anxiety and depression. They usually have advanced training in these areas. They can practice most any type of massage and have take advanced training in how to apply what they know to medical conditions. There is not one type of massage that is called medical massage.

To get your health insurance to cover massage therapy, you need to start asking for coverage in your health insurance. If you work for a company that provides your insurance, start asking them to find plans that cover massage therapy. Washington State health insurance plans have covered massage therapy since about 1996 when a law was created called the Every Category Law which made is so insurance carriers had to cover massage therapy, as well as acupuncture and Naturopaths. It was created by the insurance commissioner at the time – Deborah Senn. She created the law and it was fought by the insurance carriers but the OIC won and the law was enforced making it so massage therapy was covered by insurance. There was even a supreme court decision that ended the battle enforcing the law.

Ask your insurance commissioner to create such a law and enforce it. Ask your legislators to start working on it with the insurance commissioners.

You may also be able to find a massage therapists that specialized in treating injuries and conditions and who might want to blaze the trail for getting massage therapy covered by health insurance. They can take your case and try to bill your massage sessions and see if they can get paid. The insurance companies will at first deny claims and it may take time to appeal the case. You can tell your massage therapist that I have a guide to billing insurance and some tips on appealing cases available. See: Massage Insurance Billing: Healthcare integration and Advocacy.

If you were in a car accident or hurt at work, massage therapy may be covered in your state. You will have to verify your benefits with your workers compensation claim manager or motor vehicle accident claim manager.

For Massage Therapists

Being able to bill health insurance for your massage therapy sessions has always been a dual edged sword. On one side, we want massage therapy to be seen as healthcare and we have seen what it can do for many different conditions. Having Medicare/Medicaid cover massage therapy and all health insurance plans cover massage would make massage more accessible to many especially those who need it but cannot afford it. The other side is that the healthcare system has much to be desired. The allowable fees are usually less than a massage therapists cash rate and make it difficult to make a living.

Washington State massage therapists have been able to bill health insurance since about 1996 after a 3 year court battle between the insurance commissioner at the time (Deborah Senn) and the insurance carriers. It is a well documented battle which ended in the insurance commissioner winning making it so massage therapy in WA state is covered by health insurance. (See the Report of the Clinician Workgroup on the Integration of Complementary and Alternative Medicine January 2000.  Factual Chronology Of Legal Events Related to RCW 48.43.045 April 1993 The Washington State legislature adopted the “every category of provider” mandate as part of the 1993 Health Care Reform Act. Link to my other website.)

For many years there have been many groups calling for the inclusion of massage therapy into healthcare, yet there is no organized effort to make it happen. I have written about the history of massage therapy in healthcare and how we need to get to the table if we want this to be included and paid by health insurance. (There is power in numbers and the more massage therapists that get involved, the more influence we can have.)

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