Health Insurance: Let me help you through the Maze!

Do you need massage therapy to help treat for a medical condition or illness but are unsure of your health coverage benefits? I can help you navigate through the maze!

Call ahead of your appointment to check your benefits personally or have me call your insurance company to get an idea of expected cost/coverage. You may need to meet your deductible before you can access massage benefits.

Some companies require a prescription, referral, or pre-authorization. Country Massage is a 1-employee independent business so be aware that benefit checks are done as a courtesy but doesn’t guarantee payment by the company or guarantee approval by the company.

I am not a health insurance specialist and I do not outsource my claims. While I do my best to make massage affordable and accessible I cannot continue as a successful business if I am wrapped up in long calls, appeals for claims, and waiting months for payment. If you have any questions about the new changes I’ve made please let me know.

Things to keep in mind

• Massage can be covered by group plans but not individual plans

• Some plans cover massage only if it is done in a chiropractic office or under supervision of a physical therapist

• Some plans offer massage benefits without a prescription or need to meet deductible first

Things to ask Insurance Company:

1. Do I have insurance coverage for massage therapy? (Code for massage therapy is 97124 or 97140 for manual therapy)

2. Do I need a pre-authorization, prescription or a referral?

3. Is massage subject to the deductible? What is my individual deductible?

4. What is my copay or coinsurance?

5. How many total visits do I have for massage? Is the number of visits shared with any other type of care like physical therapy/occupational therapy, alternative therapies.

6. Is massage measured in units or minutes? What is the maximum treatment time allowed?

Do you have a Health Savings Account?

If unfamiliar with the HSA, it takes pre-tax money from your paycheck and places it into an account for medical spending where in many cases massage therapy is covered.

To confirm if massage therapy can be used with your HSA, check with your benefits administrator first. Sometimes medical necessity is required. To make a payment you simply use the debit card linked to your account at the time of treatment.

* A quote of benefits and/or authorization does not guarantee payment or verify eligibility. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at time of service.

Insurance Companies I work with:

• Regence Blue Cross/Blue Shield of Oregon

• Premera Blue Cross

• Aetna Health Insurance Companies

• Cigna (Oregon only)

• Soon: EOCCO/OHP(Medicaid) of rural counties in Eastern Oregon

• Soon: Medicare supplemental insurance plans

• United Healthcare

• Health insurance savings plans/Flexible Savings Accounts

• ASH

• Optum

• Lifewise

• First Choice Health Network

Insurance Companies I don’t work with:

• MODA

• Worker’s Compensation cases

• MVA/Personal insurance protection cases/automobile insurance companies

• Kaiser Permanente

• TriCare West

• Out of state insurance companies

• Providence

• Pacificsource

  **Insurance plan requirements change each year. 

If “out-of-network” with your insurance company, payment is due at the time of service; your insurance company will reimburse you for payment.  I am happy to provide any codes needed and receipts for you to submit your own claims for reimbursement but I won’t submit claims for you if your carrier is on this list. Thank you for your understanding.