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  • No, I Don’t Think Massage Should be Covered by Insurance

    insurance coverage“I wish my insurance covered massage,” is a lament I hear quite frequently, and I totally understand it. Massage can be a bit pricey, especially if you’ve gone and gotten yourself a bit jacked up and need a lot of work in a fairly short span of time.

    For the record, I also sometimes wish that my medical insurance would cover the massages I get, because, like you, I’m not made of money. But I know that won’t always give me the best outcome. It’s not that I don’t want us to have some help paying for massage, but current insurance company policies aren’t always conducive to getting the best therapeutic massage outcome possible.

    Let me tell you a story that will help explain why I’m against insurance coverage for massage… at least for now.

    Many years ago, I had a horrible, searing pain in my right arm and I was unable to function. I was unable to do anything but cry uncontrollably unless I was lying flat on my back. Then I was at least able to just moan in pain, instead of cry. I went to the doctor and was diagnosed with a pinched nerve in my neck and sent to physical therapy.

    At this time, I had been a massage therapist for a couple of years and knew that the nerves that run into your arm have more than one spot where they can be pinched. I noticed, quite quickly, that the physical therapist only ever worked on my neck. She never worked any of the other places, like my shoulder area, where those nerves could be pinched. The neck work barely gave me any noticeable relief so I asked her about working my shoulder area since that’s an area that the nerves which were causing my pain often get pinched.

    Her response was illuminating. She told me that if I wanted my insurance to pay for the PT, she had to confine her work to my neck, because I only had a diagnosis for nerves being pinched in my neck, not my shoulder. She totally agreed that since the PT was not terribly effective I most likely had an impingement (pinching) in my shoulder area in addition to my neck. She suggested that I get one of my massage therapist colleagues to work on my shoulder.

    I took her advice and it made a world of difference. It took many tries and many therapists to find one who had the right technique and the right touch (I could barely stand to be touched because of the pain), but it was the work on my shoulder that finally gave me ultimate relief.

    A few years after that incident, clients started showing up who’d been through several rounds of PT before they gave up on it and decided to pay out of pocket and try massage. Most of them had the same diagnosis I had had, cervical radiculopathy. (That’s the official fancy-pants name for a pinched nerve in the neck.) Lo and behold, I’d work on their shoulder, because I don’t have the constraints of an insurance company, and most of them got relief.

    Sometimes I’d work just the shoulder, sometimes the neck and shoulder, sometimes the upper body, and sometimes I’d work the entire body, depending on their stress level, personality, how well they responded to the work and how much tension they had in the rest of their body.

    If their insurance had been paying, I’d have been confined to the neck area like their physical therapists had been.

    It’s not just work on pinched nerves that would be affected by insurance coverage, it’s all therapeutic work. Headache work, for instance, would be affected as well. I can almost guarantee that no insurance company would allow me to work someone’s hip muscles when they have a diagnosis of chronic headache, even though the hip muscles are implicated in many tension headaches.

    I could go on and on with examples, but I think you get my point.

    The battle over healthcare reform and the best way to deliver affordable care is threatening to turn into an all out war, so I don’t think the situation is going to change anytime soon. In the meantime, if you have a flex spending account (FSA)* through work or a health savings account (HSA)*, that’s going be your best bet for paying for your massages. At least then you’ll get a few tax breaks for getting massage.

    *Note: Only licensed healthcare providers can accept HSA and FSA payments. Many states, but not all, license their massage therapists as healthcare providers. Check with your massage therapist to see if they accept those forms of payment prior to making an appointment.

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