Does Medicare cover aquatic therapy?
Does Medicare cover aquatic therapy? Medicare Part B will cover aquatic therapy and other physical therapies if they are medically necessary. There are no longer any limits to the number of sessions. Medicare Advantage should also cover aquatic therapy, but you should contact your policyholder with questions. Read more below about Medicare physical therapy coverage.
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Tracey L. Wells
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Tracey L. Wells is a licensed insurance agent and Farmers insurance agency owner with 23 years of experience. He is proud to be a local Farmers agent serving Grayson, Georgia and surrounding areas. With experience as both an underwriter and agent, he provides his customers with insight that others agents may not have. His agency offers all lines of insurance including home, life, auto, RV, busi...
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UPDATED: Dec 22, 2024
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UPDATED: Dec 22, 2024
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- Medicare Part B will cover aquatic therapy, along with other physical therapies, as long as they are medically necessary.
- Medicare Advantage plans should also cover aquatic therapy and other physical therapies, but you should contact your policyholder with any questions.
- Your out-of-pocket expenses may include premiums, deductibles, and copayments or coinsurance. Medigap may help cover these.
Your doctor may recommend aquatic therapy if you have musculoskeletal, neuromuscular, cardiovascular, or other disorders. It is conducted in a (usually heated) therapy pool.
But does Medicare cover aquatic therapy? Will you have to pay any out-of-pocket costs for the sessions? We’ll answer these questions and more your Medicare health insurance coverage below.
Before you begin reading, be sure to find health insurance rates near you by using our free insurance quote comparison tool above. Enter your ZIP code to get quotes from health insurance companies in your area. Not yet ready to buy health insurance? Read on to learn more.
Does Medicare cover aquatic therapy?
Medicare Part B will cover aquatic therapy as a type of physical therapy as long as it is considered medically necessary.
Medicare Advantage plans must be the same as or better than original Medicare, so they will most likely cover aquatic therapy as well, but you should contact your policyholder for details.
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What other physical therapies does Medicare cover?
Medicare Part B will cover any outpatient therapy services that are medically necessary. While Medicare used to limit the number of services you could receive, this is no longer the case. You can attend as many of these sessions as needed.
Medicare Advantage plans will also cover medically necessary outpatient physical therapies. Your plan provider will have more details regarding your specific policy.
You may seek out services from physical therapists, speech-language pathologists, and occupational therapists, as well as doctors and other healthcare providers who offer these services. However, the healthcare provider and their facility must accept Medicare.
You may still face out-of-pocket expenses, such as premiums, deductible ($203 as of 2021), and copayment or coinsurance. If you have a Medigap plan, you may be able to get help paying for these.
Case Study: Medicare Coverage Analysis of Aquatic Therapy for Rehabilitation and Pain Management
Case Study 1: John’s Recovery Journey
John is a 65-year-old retiree who recently underwent knee replacement surgery. His doctor recommends aquatic therapy as part of his rehabilitation program to improve joint mobility and strength.
John is enrolled in Medicare Part B, which covers outpatient services, including physical therapy. Aquatic therapy falls under this category. However, Medicare requires that the therapy is deemed medically necessary and provided by a qualified healthcare professional.
John’s physician submits a referral for aquatic therapy, stating the medical necessity due to John’s knee replacement surgery. The therapy sessions are conducted by a licensed physical therapist at an approved facility. Medicare covers a portion of the costs, and John pays the remaining deductible and coinsurance.
Through aquatic therapy, John experiences improved mobility and successfully recovers from his surgery.
Case Study 2: Sarah’s Arthritis Management
Sarah is a 72-year-old Medicare beneficiary diagnosed with rheumatoid arthritis. She experiences joint pain and stiffness, affecting her ability to perform daily activities. Sarah’s rheumatologist suggests aquatic therapy as a non-pharmacological treatment option to manage her symptoms.
Medicare Part B covers outpatient services, including physical therapy, if they are considered medically necessary. Aquatic therapy can be deemed medically necessary for individuals with conditions like arthritis, as it provides a low-impact environment that reduces stress on joints.
Sarah’s rheumatologist submits a referral for aquatic therapy, highlighting the medical necessity of the treatment for her arthritis management. The therapy sessions are conducted by a licensed physical therapist at an approved facility.
Medicare covers a portion of the costs, and Sarah is responsible for the deductible and coinsurance. Aquatic therapy helps Sarah alleviate pain, improve joint flexibility, and enhance her overall quality of life.
Case Study 3: Mark’s Non-Covered Aquatic Therapy
Mark is a 70-year-old Medicare beneficiary who suffers from chronic lower back pain. His chiropractor recommends aquatic therapy to alleviate his symptoms and improve his functional capacity.
Although aquatic therapy can be beneficial for certain conditions, Medicare’s coverage guidelines require that services be considered medically necessary. In Mark’s case, Medicare may consider aquatic therapy as a non-covered service if it does not meet the necessary criteria.
Mark’s chiropractor submits a referral for aquatic therapy, but it is deemed not medically necessary by Medicare. Consequently, Medicare does not cover the therapy costs. Mark decides to pay for the therapy sessions out of pocket, as he believes the potential benefits outweigh the expense.
Despite the lack of Medicare coverage, Mark finds relief from his back pain and experiences improved mobility through the aquatic therapy sessions.
The Bottom Line
Medicare Part B will cover outpatient aquatic therapy, along with other types of physical therapy as a continued treatment, as long as they are considered medically necessary. There are no longer any limits to how many sessions you can complete.
Medicare Advantage plans will also cover outpatient physical therapies, but you should contact your individual policyholder to ask for details.
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Frequently Asked Questions
Does Medicare cover aquatic therapy?
Yes, Medicare does cover aquatic therapy under certain conditions. Aquatic therapy, also known as hydrotherapy, is a form of physical therapy that takes place in a pool or other water-based environment.
Do I need a referral from a doctor to receive aquatic therapy?
Yes, you will need a referral from a healthcare provider, such as your doctor, to receive coverage for aquatic therapy under Medicare.
Do I need to meet a deductible for aquatic therapy under Medicare?
Yes, you will need to meet your Medicare Part B deductible before coverage for aquatic therapy begins.
Are there any out-of-pocket costs associated with aquatic therapy under Medicare?
Once you have met your Part B deductible, Medicare typically covers 80% of the approved amount for aquatic therapy. You will be responsible for the remaining 20% as well as any applicable coinsurance or copayments.
Can I receive aquatic therapy in any pool?
For Medicare coverage, aquatic therapy must be conducted in a pool that meets certain standards and is supervised by qualified personnel, such as a licensed therapist.
How do I find a Medicare-approved facility that offers aquatic therapy?
You can find a Medicare-approved facility that offers aquatic therapy by using the Medicare.gov “Find a Provider” tool or by contacting your Medicare plan provider for a list of in-network providers.
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Tracey L. Wells
Licensed Insurance Agent & Agency Owner
Tracey L. Wells is a licensed insurance agent and Farmers insurance agency owner with 23 years of experience. He is proud to be a local Farmers agent serving Grayson, Georgia and surrounding areas. With experience as both an underwriter and agent, he provides his customers with insight that others agents may not have. His agency offers all lines of insurance including home, life, auto, RV, busi...
Licensed Insurance Agent & Agency Owner
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.