INDIANA – Medicare, the U.S. federal health insurance program, provides coverage for a wide range of services to help individuals manage pain safely and effectively. These services are primarily covered under Medicare Part B (Medical Insurance) and Medicare Part D (prescription drug coverage).
Covered Services
Medicare Part B covers many non-medication treatments for pain, including:
- Acupuncture for chronic low back pain.
- Physical therapy and occupational therapy.
- Chiropractic services.
- Chronic pain management and treatment services.
- Mental health and substance disorder services, including opioid use disorder treatment services, are covered for as long as a person needs them.
- Screenings for depression and alcohol misuse.
If your doctor prescribes pain medication, Medicare Part D plans may offer programs like Medication Therapy Management to help you use these prescriptions more safely.
Costs in Original Medicare
For most pain management services covered under Original Medicare, you are responsible for paying 20% of the Medicare-approved amount after meeting your Part B deductible.
It’s essential to note that if you receive services in a hospital outpatient clinic, you may be subject to an additional copayment or coinsurance. However, you pay nothing for a yearly depression screening if your healthcare provider accepts assignment.
For an accurate estimate of your out-of-pocket costs, consult with your doctor or healthcare provider. The final amount you owe can depend on factors like other insurance you may have, your doctor’s charges, and the specific facility where you receive care.
Important Considerations
While Medicare covers many services, your doctor might recommend additional treatments that are not covered, such as massage therapy. If this happens, or if you need services more frequently than Medicare covers, you may have to pay some or all of the costs yourself. Always ask your doctor about why a service is recommended and if Medicare will cover it.
There are many ways to manage pain, and it’s best to discuss all your options with your doctor. They may suggest alternative treatments, such as meditation, tai chi, or yoga, in addition to Medicare-covered services.
