What’s the difference between what Original Medicare covers and what a Medicare Advantage plan might include for holistic care?
Answered by 18 licensed agents
Its been my experience that holistic care, by and large is not covered with the exception of some Medicare advantage plans covering acupuncture. Vitamins can be a covered expense on some over the counter plans with Medicare advantage plans as well.
Medicare Advantage plans are required to offer all the same coverage as Original Medicare, but many also bundle in extra health and wellness benefits. This is where coverage for holistic care can expand significantly. The specific benefits vary by the private insurance company, the plan, and the local area.
Medicare itself does not cover holistic care at all. Some Medicare advantage plans will give you discount discounts or a small co-pay for that kind of care. Medicare supplements usually do not cover holistic care.
Holistic care traditionally is not covered by Medicare. Advantage Plan carriers see the integrated medicine modalities as a counter measure to traditional medicine and include some benefits in many of their plans.
Your Naturapath must be contracted with Medicare to accept Medicare payments, and you will pay 20% of the cost. In Eastern WA, many Naturapaths do not accept Medicare or Medicare Advantage plans. Best to check with your medical provider to see if they accept Medicare payments and/or Medicare Advantage payments from your plan.
Original Medicare is pretty limited with holistic care and mostly sticks to medically-necessary treatment. Medicare Advantage plans can sometimes include extra wellness benefits, like acupuncture, chiropractic, fitness programs, or over-the-counter allowances. It depends on the plan, so it’s something we compare to see what fits your needs.
Holistic care for an advantage plan would have to be something an in network provider will perform, while a with original Medicare you’re able to go to any holistic provider that’s willing to bill Medicare and bills based on Medicare covered benefits.
The main difference is that Original Medicare offers very limited, specific coverage for holistic care, while Medicare Advantage plans can offer broader, supplemental benefits for a wider range of wellness services.
Original Medicare does not cover holistic care. Some Medicare Advantage plans have limited coverage for chiropractic and acupuncture but typically holistic care is not covered
only — hospital care, doctor visits, tests, and limited chiropractic. It doesn’t cover most holistic or alternative therapies.
Medicare Advantage plans, on the other hand, may offer extra wellness benefits like acupuncture, expanded chiropractic, fitness programs, or other holistic options. These added benefits depend on the specific plan, so it’s important to compare what’s available in your zip code.
Original Medicare, Parts A & B do not cover holistic medicine and care. Medicare Part C, Medicare Advantage plan may cover holistic medicine and care as long as it is done by a licensed practitioner.
Original Medicare provides very little coverage for holistic or alternative care — it only pays for a few very specific services like chiropractic spinal manipulation for an active subluxation or acupuncture for chronic low back pain.
Medicare Advantage plans may offer some holistic benefits, but it varies widely by plan and is never guaranteed. These extras can change every year, may require prior authorization, and often come with limits.
So the honest answer is: it depends — but in most cases, holistic care is not covered under either option.
Original Medicare is extremely limited when it comes to holistic care. Some medically necessary chiropractic services may receive coverage, but things like acupuncture, massage therapy, naturotherapy, and other services are not covered. Medicare Advantage plans may offer extra benefits like acupuncture or additional chiropractic care, but coverage is not guaranteed and varies by plan and carrier.
Medicare Advantage(Part C) plans may offer more extensive coverage for holistic services like acupuncture or fitness programs, though these benefits may vary by plan and requires providers to be medically accepted or licensed as well as be in-network providers. Advantage plans commonly include vision, hearing, dental, and wellness benefits, benefits which are not covered by original Medicare.
Medicare Advantage plans are managed care plans and those benefits accessible to you are determined by the particular plan you selected. More often than not, there are many holistic modalities to health care that would be approved under original Medicare rather than a Medicare Advantage plan. To truly understand what your individual needs are I would recommend you sit down with a licensed insurance agent that specialiezes in the nuances of Medicare in your county of residence.
