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.
REAL massage is massage that is given by Responsible, Ethical, Accountable, and Licensed Massage Therapists. (REAL Massage is the concept of the American Massage Therapy Association WA Chapter - see www.amta-wa.org) .
Massage is therapeutic and relaxing but it also has become a haven for prostitutes to hide behind the concept of massage. Massage therapists are trained and licensed in the state of WA and are licensed as health care providers.
Prostitutes and the many TV dramas like the Client List have made it difficult and confusing for consumers of massage. Many may believe that happy endings are now a part of professional massage when of course they are not.
There is just no other way to say this but Happy Endings are illegal acts of prostitution. You will be arrested and jailed for getting one.
The Police are actually cracking down on such illegal places using massage for a front for prostitution. Just recently in Yakima , 6 spas were closed down. See Yakima Herald - Yakima cops close 6 Asian massage parlors, arrest Sept 7 2014.
Asian spas/massage places are often the culprit although not all Asian Massage is doing this. Asian Massage is a legit form of massage that is getting a bad name by so many being associated with the illegal type of massage being done in these places.
Foot Massage Spas have also been a problem in WA State. Many of them were operating illegally in WA under the idea that they were only massaging feet. Most often these foot spas offer $25 or even less for their massage for feet. They also usually do massage on the rest of the body through the clothes. The people giving massage at these places were unlicensed and providing massage illegally. That means that they are untrained in the art and science of massage and pose a risk to the public. The do not screen people for diseases and conditions that may be contraindicated making it a risk to get a massage there.
Last year, the WA State Board of Massage made it so people giving foot massage had to also now get a massage license and receive proper training from an approved massage school. Check to see if the foot massage spa you are going to has licensed massage therapists. Their licenses should be on the wall! You can also check with the WA State Board of Massage Provider Credential Search
Make Sure you are getting a REAL massage! The license number of legitimate massage therapists should also be on every website and every marketing brochure.