I accept Regence Blue Shield and Premera Blue Cross. Both Companies require that you have a pain condition AND a loss of function.
That means that you MUST also have some degree of not being
able to sit, stand, walk, stair climb, lift, work, personal care, drive, or sleep because of or in addition to your pain.
Each has different requirements and benefits that you will need to know and be responsible for. Please read more at these pages: Regence Blue Shield and Premera Blue Cross
ALL Plans require that massage therapy be medically necessary and each plan has their own specific definition of what that means. Check your policy. Here are some sample definitions of medical necessity.
All insurance claims must have a prescription from your doctor with a diagnosis in order to be processed, no matter what the insurance company says. A prescription is different from a referral. Some plans will say that you do not need a referral, but you still will need a prescription. A prescription will provide a diagnosis code and a treatment plan stating the number of sessions the doctor is prescribing and the duration. (Example: 1x a week for 6 weeks)
You will be allowed 6 sessions to be completed without prior-authorization. After that, your insurance requires that I obtain a prior-authorization from a company they have hired called eviCore, before completing more sessions.
Insurance will only cover
massage if there is an injury or condition that makes it medically
necessary to get a massage. Medically necessary massage therapy is done once or twice a week depending on the prescription and condition.
It does not cover massage just for stress, anxiety or depression.
It does not cover maintenance or preventative massage. Each insurance company has their own definition of maintenance massage. I define it as massage therapy done once a month, every three weeks or every other week. Massage must be done (time allowing) once a week for massage to give the best benefits. I have to show that there is improvement in your condition.
It does not cover soreness due to exercise.
Some of the conditions that massage can help and that your health insurance will cover are:
Use this handy insurance verification form (PDF) if you call your insurance to investigate your massage therapy benefits.
Good news! Massage can help with depression and anxiety. That is one thing that we know for sure about massage from what the research tells us. The one problem is that it is not yet covered on insurance.
Depression is a debilitating problem. There are many different levels and kinds of depression but the one thing is sure - depression is often the cause of more serious illnesses and conditions. Depression can show up as that feeling of hopelessness or not having enough energy to get through the day. It is when you feel like you can't get out of bed in the morning or you are up all night. You can be depressed after the death of a loved one or pet or depressed after childbirth.
While massage therapists are not psychotherapists, massage has been shown to work even better for depression than psychotherapy!
This Meta Analysis of Massage Therapy Research. by Christopher Moyers says:
“Reductions of trait anxiety and depression were MT’s largest effects, with a course of treatment providing benefits similar in magnitude to those of psychotherapy”
A meta-analysis is research that studies all of the other research and puts it all together to find out what works best! It is the strongest level of research there is and this shows that massage for depression can really help.
We don't actually know much about how massage works. The theories that we do have are about how touch works. Touch is what soothes and heals the aching mind and body.
Our first approach is through the body but the body is connected to the mind. When a massage technique is performed on the body, it has a way of creating an experience of being held or nurtured. Often it is not the technique or method being used but just taking time for yourself to get the attention you need.
Touch lets you get to know yourself better. Many people receiving massage will often say things like "I came in with neck pain and left being nicer to my co-workers and partner/family members". Many under stress and in pain will lose sight of what is important and massage also has a way of helping people to come to realize just what is more important to them. I often see people come in and leave making big changes in their lives that help them feel more fulfilled.
It isn't magic. It is just what a massage does!