Medicare added limited acupuncture coverage, but only for one condition. Here's exactly what qualifies.
When does Medicare cover acupuncture?
Medicare Part B covers acupuncture only for chronic low back pain, defined as pain lasting 12 weeks or longer that has no identifiable systemic cause like cancer or infection and isn't linked to surgery or pregnancy. Medicare covers up to 12 visits in 90 days. If your symptoms improve, you can get up to 8 additional treatments, for a maximum of 20 acupuncture visits per year. Treatment must be provided or directly supervised by a qualified, Medicare-recognized provider. You pay 20% of the Medicare-approved amount after your Part B deductible. To check your coverage, call 1-800-MEDIGAP at 1-800-633-4427.
What acupuncture is not covered, and your options
Medicare does not cover acupuncture for any condition other than chronic low back pain, so treatment for migraines, arthritis, nausea, or general wellness is not covered under Original Medicare. If you stop improving, Medicare won't continue paying, and treatments beyond the annual limit are out of pocket. Some Medicare Advantage plans offer broader acupuncture or other complementary care benefits as extras, varying by plan and area. A Medigap plan can help cover the 20% coinsurance on the acupuncture Medicare does cover. Call 1-800-MEDIGAP at 1-800-633-4427 to compare plans that may offer more.