Can you take my insurance? Part Two

Navigating insurance can be complicated. Unfortunately, there are several reasons using your insurance might not be an option.

The most common reason I come across is that massage benefits aren’t included in a plan. Blue Cross Blue Shield plans from outside of Washington State often exclude massage completely or it is only covered if done by a medical doctor or chiropractor. Serious let down. What M.D. or chiropractor will take an hour to give you the massage you need? I’ve met a couple of chiropractors who will do quick treatment massage, but only about 15 minutes and it isn’t anything like a “regular” massage. This problem is not limited to just Blue Cross Blue Shield plans, but can affect any other insurance companies plan as well.

As a side note: I actually had a person at Blue Cross Blue Shield tell me that the company plans exclusively don’t include massage at all unless it’s written into a specific plan – and never by a massage therapist (again unless it’s written into a plan). That’s just their policy. Who knows if this is completely accurate. I’ve been misinformed by people at insurance companies before.

The most frustrating complication I’ve run into is this: a client says they have used their massage benefits many times before (usually it’s Blue Cross Blue Shield). I call to check on their insurance and I’m told what I just explained – it’s only covered if done by a chiropractor or M.D. not if performed by a licensed massage therapist/practitioner. Well, here is the super frustrating thing: this happens all over the place because within a certain office, the chiropractor or whomever decides to have the in house massage therapist perform the massage but bill it under his/her name. If this doesn’t sound legal to you, that would be correct. I’m not a lawyer but I believe that this constitutes as  fraud.

This situation is  incredibly irritating to me because I have to be the bearer of bad news to the client who swore up and down they had benefits they could use. Sorry, actually you didn’t – it wasn’t being done legally and it mislead you.

Now I will say that even though it is illegal, I understand why some healthcare practitioners do this. Health insurance companies often don’t make it easy to use preventative, holistic healthcare. So if a practitioner breaks a rule and it benefits the client/patient sometimes the harm is harder to see. I don’t condone this, but I do understand. The harm comes later when they go somewhere else expecting that things will be hunky-dory this time around.

Moral of the story? Let me call your insurance even if you are sure you have massage benefits.




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