Does Medicare Pay for Holistic or Alternative Medical Treatments?

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As we age, the less reliant people want to be on medications and instead seek ways to adopt a healthier way, holistic way of living. Alternative medicine has been the preferred option among many older adults in the U.S. to enhance their quality of life. Research has shown that seniors have turned to alternative modes of health care to feel better about themselves and to extend their years, with the likes of massage therapy, yoga, chiropractic care, acupuncture, and transcutaneous electrical nerve stimulation (TENS) exhibiting promising and enduring results.

With the enhanced role of holistic treatments in the improvement of senior citizens’ quality of life, it is only expected that Medicare programs would include them in their coverage. However, as most of these procedures are still experimental and do not have ample scientific research to back them as safe and legitimate treatment options, Medicare’s coverage is also limited. So does Medicare pay for holistic or alternative treatments? The answer is both yes and no.

Medicare Coverage: Holistic Medicine

Medicare does not cover alternative medicine, save for specific procedures that may be necessary for obtaining other regular healthcare treatments that fall under Medicare’s scope.

An example is chiropractic care that is needed for spinal manipulation-related procedures, which Medicare Part B shoulders. Another example is medical nutrition therapy, again under Part B, because it is part of the program for patients who have been diagnosed with a kidney disease or diabetes, or those who have undergone a kidney transplant within the last 36 months. Medicare will consider covering part of this service or the full bill, provided that patients have a referral from a qualified practitioner or their doctor.

Counseling is also not part of Medicare coverage, although you may avail of Medicare-approved services similar to this one, such as mental health therapy sessions and depression screenings.

Alternative Treatments Not Covered by Medicare

To be clear, there are alternative treatments that are really not covered under Medicare because they are not typically a prerequisite to any inpatient or outpatient procedure that qualify for free billing or subsidy. Most of these holistic treatments are taken as adjuncts to an existing medical plan or as second option by those who refuse traditional medical invention. As a general rule, Medicare shoulders procedures that are prescribed by medical doctors and are obtain through hospital care or outpatient clinical services.

Procedure
Covered by Medicare?
Acupuncture
No
Chiropractic services
Yes, Part B, but only when they are medically needed to correct spinal subluxation
Fitness programs
No
Health education and wellness programs
No
Humidifiers
No
Massage therapy
No
Naturopathic medicine
No
Nutrition therapy services
Yes, Part B, but there are specific qualifiers
Obesity screening and counseling
Yes, covers sessions to help patients lose weight in a primary care environment run by a qualified provider
Sleep apnea
Yes, Part B, but for a three-month trial session of CPAP therapy by a qualified provider.
Sleep studies
Yes, Part B. Medicare takes care of Type I, II, III, and IV sleep exams and devices.
Smoking cessation
Yes, Part B. Medicare shoulders up to eight in-person counseling sessions in a year with a qualified provider.

Medicare Part D and Holistic Treatments

  • Part D will only cover prescription drugs that meet these conditions:
  • With a Food and Drug Administration (FDA) approval
  • Available only by prescription
  • Used for a medically-approved purpose
  • Sold and used in the U.S.
  • Not already covered in Part A or Part B

That said, drugs that promise to help you gain or lose weight, fix sexual or erectile dysfunction, grow hair and other cosmetic purposes, prescription vitamins and minerals (except fluoride preparations and prenatal vitamins), fertility drugs, and over-the-counter drugs are not covered.

To understand how Medicare and Medicare Supplements (Medigap) play a role in your alternative approach to your senior years, it’s best to talk with a qualified SecureCare65 representative so you can weigh all your options first before making a decision. Talk to us at 1-800-354-1078.