Coverage restrictions by Medicare and private insurers prevent seniors from fully leveraging the potential benefits of alternative medicine therapiesEnsurem CEO Dave Rich urges insurers to catch up with modern times.
(Clearwater, FL) December 21, 2020—People are not only living longer, but according to recent research from Duke University, they’re also living better. Today’s seniors are increasingly healthier in mind and body as they age than ever before.1 They are also staying busier during their Golden Years than in years past. Over the last 20 years, the percentage of Americans working in their 70s has risen from less than 10% to 15%.2 “Today’s seniors are much more different than what they were in years past. Medicine and insurance have to catch up,” says Ensurem CEO Dave Rich.
As people live longer and continue to be active, they increasingly rely on healthcare professionals not just to heal them when they are sick, but to also provide services that enable them to live full, active lives. This often includes services generally classified as alternative medicine, such as massage therapy, chiropractic, naturopathy and acupuncture.
According to Rich, chiropractic care is one of the most commonly requested by his company’s Medicare insurance clients. He also notes that 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.3
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.4However, Medicare categorizes massage therapy as an “alternative treatment,” one not deemed medically necessary, and so it is not covered by original Medicare parts A and B.
Some Medicare Advantage plans will cover massage therapy, Rich notes, but only if the therapy is related to a specific injury or illness. In these cases, policyholders are generally required to first obtain an order or prescription from an in-network doctor to treat the covered medical condition. 5
This, says Rich, is outmoded thinking; it is designed purely to cut costs and is having exactly the opposite effect. There are currently 1.4 million Americans living in nursing homes 6 at an average cost of $48,000 per year.7 Meanwhile, every day, 10,000 members of the Baby Boom Generation celebrate their 65th birthday, the age at which one becomes Medicare eligible. “The insurance industry needs to do better to ensure seniors have the ability to receive not only treatment but also preventive measures that in the long run will actually save insurers money,” Rich says. “Insurers, legislators and officials at every level need to understand that easy, insurance-covered access to health-maintaining alternative medicine modalities is neither a luxury nor a frill and is certainly not a waste of money. It is an economically sound investment in a better, cheaper, healthier and longer future for today’s and tomorrow’s seniors.”
Until Medicare allows seniors to seek appropriate treatment not just for a covered injury or sickness, but to help maintain overall strength and vitality, Rich urges seniors to carefully examine any healthcare insurance program they are considering putting their money into to make certain they will have the coverage they need not just to get well, but to stay well.