Does Medicare Cover Alternative Medicine & Wellness?

Complementary health approaches like alternative medicine and integrative medicine continue to grow in popularity, with the market expecting to grow 25.3% from 2024 to 2030 . Many rely on these more unconventional approaches for things like pain management, or simply as a complement to their existing medical care.

With this growing reliance on alternatives to traditional medicine, many who are approaching the age of 65 may find themselves asking: does Medicare cover alternative medicine?

What Counts as Alternative or Integrative Medicine? Before we get into Medicare’s coverage of non-traditional medicine, it’s important to establish a distinction between alternative, integrative, and complementary medicine:

As the name suggests, alternative medicine is an alternative to traditional medicine , which replaces or accompanies standard medical practices with different medicines and therapies like herbal treatments and naturopathy. Integrative medicine combines traditional medicine with complementary practices . An example of this would be supplementing chemotherapy with acupuncture and meditation to maintain mental wellbeing. Complementary medicine refers to the non-traditional approaches that are used in integrative medicine . Think of it like this: complementary medicine + traditional medicine = integrative medicine, which we go more into below. What Do People Use Complementary Medicine For? Amongst those who are 65 and older, complementary medicine is generally additional treatment, often in the form of holistic wellness, mental health, and pain management. For example, someone may choose to accompany traditional anxiety treatment with hypnosis.

While Medicare’s coverage of these types of services is fairly limited, there are some exceptions.

A general rule of thumb to keep in mind is that Medicare generally covers “medically necessary” services, which means that many services that healthcare providers deems essential will likely be covered by Medicare. This is true even if the service falls into the category of “complementary medicine”.

Does Medicare Cover Alternative Therapies? To help simplify things, we’ll cover both alternative and complementary medicine, and how Medicare handles each.

Medicare & Alternative Medicine Medicare doesn’t generally cover alternative medicine that is used in place of traditional therapies. However, it does cover a few things that fall under complementary medicine, as they are used alongside conventional treatments.

Original Medicare & Complementary Medicine Under Original Medicare (Parts A and B ), the coverage of complementary medicine is very limited. In most cases, the need for complementary services must meet two primary conditions:

The service must be deemed medically necessary for diagnosis or treatment of an illness or injury. The service must be performed by a Medicare-recognized provider or facility. That being said, Original Medicare does cover:

Acupuncture for low back pain is covered for up to 12 visits in 90 days, with an additional 8 sessions possible if improvement is shown. The situation must also meet the following conditions: Pain must last 12 weeks or longer Pain cannot be caused by cancer, pregnancy, or certain other conditions Chiropractic spinal manipulation is covered if intended to correct a diagnosed vertebral subluxation. Any related exams, X-rays, or therapies are not covered. Osteopathic manipulative treatment (OMT) is covered when performed by a Doctor of Osteopathy (DO) for a reason deemed medically necessary. Outside of these cases, most alternative medicine services remain excluded from Original Medicare coverage.

Medicare Advantage & Complementary Medicine Medicare Advantage (Part C) plans are offered by private insurers, and cover all of the same things that Original Medicare does, but with extended coverage for specific things, often including complementary medicine. Depending on the specific Medicare Advantage plan, these could include:

Additional coverage for acupuncture (beyond chronic low back pain). Coverage for massage therapy ; keep in mind that this may come with visit limits. Access to integrative medicine specialists within the plan’s network. Wellness coaching services such as nutritional counseling. Discounts or memberships for fitness programs . These benefits may sound enticing to some, but the trade-off to keep in mind is that Medicare Advantage plans have specific provider networks and cost structures, amongst other differences . If alternative medicine is a priority, comparing plan benefits side-by-side—using a tool like Healthpilot—during enrollment is essential.

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Other Considerations: Out-of-Pocket Costs & Limitations Even when Original Medicare or your Medicare Advantage plan covers an alternative therapy, there are still associated costs to consider:

Medicare Part B , which is present in both Original Medicare and Medicare Advantage, has a deductible . This deductible applies to most outpatient services (which include complementary medicine) before Medicare starts paying. Part B-covered services also have copayments , wherein you typically pay 20% of the Medicare-approved amount. Medicare Advantage plans set their own copay rates, so be sure to review those when comparing or choosing a plan. Many covered alternative services have annual visit limits ; strict limits on the number of sessions per year. This applies to massage therapy and other complementary medicine services. As is standard with health insurance, you will be responsible for paying 100% of the cost for anything outside your Medicare plan’s coverage rules. Medicare & Alternative Medicine FAQs Is naturopathic medicine covered by Medicare? No, Medicare does not cover naturopathic medicine, including visits to naturopathic doctors (NDs), homeopathic treatments, and related supplements or therapies.

These services are considered non-medically necessary under Medicare guidelines, even if they are recommended by a provider.

Is holistic medicine covered by Medicare? Coverage for holistic or integrative medicine varies by insurer and plan type.

While Original Medicare (Part A and Part B) does not cover most holistic treatments, some Medicare Advantage (Part C) plans may include access to wellness services, integrative care practitioners, or other therapies as added benefits.

Does Medicare Cover Alternative Medicine & Wellness?

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