Does Medicare Cover Aquatic Therapy?

If you are experiencing chronic pain or need assistance recovering from injuries or surgery, you might ask yourself if Medicare will assist with your therapy. If your condition is severe and regular exercises are difficult, you should learn if this insurance plan covers aquatic therapy.

Aquatic therapy is a physical therapy that takes place in water, and it is beneficial for individuals with musculoskeletal or neuromuscular conditions, as they cannot participate in traditional physical therapy due to its complexity.

The water’s buoyancy and resistance can help these individuals increase joint and muscle strength, restore posture, and improve balance without causing excessive stress on the body. This therapy is suitable for people of all ages, as it takes place in warm water. 

While aquatic therapy has existed for some time, only a handful of people know its benefits. If your healthcare provider has recommended aquatic therapy, you might be searching for more details on the process and whether Medicare insurance will help cover the expenses.

If your doctor deems aquatic therapy an essential medical treatment, Medicare will cover it, although health insurance may not always do so. Medicare Part B specifically caters to specific medical supplies, preventive services, outpatient care, and doctor’s fees. Consequently, Medicare can assist with the cost of outpatient physical therapy, including aquatic therapy.

If your doctor recommends aquatic therapy to help alleviate pain, regain muscle mass, or recuperate from injury or surgery, Medicare will offset the therapy, provided you work with an authorized physician at a designated facility that accepts Medicare as payment.

However, you might be required to pay your deductible first, and Medicare will subsequently cover 80% of the outpatient therapy expenses. The good news is that you can get your therapy in a public swimming pool if it is closed to the public during your session.

In some cases, Medicare Part A, which often covers inpatient hospital care, may cover aquatic therapy. This often occurs if you are getting aquatic therapy as part of a hospital stay or part of a skilled nursing facility. However, this coverage is limited to a specific period and it necessitates you meet a certain criteria for quality.

On the other hand, Medicare Part C, also known as Medicare Advantage plan, is an alternative to the original Medicare offered by private insurance companies. This plan must cater to everything contained in the original Medicare, but it may also offer extra perks, such as coverage for your aquatic therapy. If you have subscribed to Medicare Part C, you should contact your plan to find out if aquatic therapy is covered and whether you need to cost-share anything.

Although Medicare Part C plans must offer the same coverage as Medical Part A and B, most comprise additional coverage. And to figure out the specifics of aquatic physical therapy, it is wise to consult with the company Clearmatch Medicare.

Suppose your healthcare provider suggests that you receive aquatic therapy. In that case, you should verify that your provider and facility accept assignments and are Medicare-approved. Medicare states that outpatient therapy should occur at comprehensive outpatient rehabilitation facilities (CORFs), skilled nursing facilities for an outpatient person, or at a doctor’s or therapist’s office. Physical therapists may conduct aquatic therapy at private facilities, rented facilities, or at their offices.

Aquatic therapy benefits individuals who cannot handle exercises involving weight lifting or those with musculoskeletal or neuromuscular disorders, such as fibromyalgia. This therapy can help alleviate joint strain by reducing the force on them and, in the process, decreases body inflammation. Exercising in the water against resistance can moderately strengthen joints and muscles, improve endurance, and help people improve their posture, balance, and gait.

Individuals with arthritis, orthopedic problems, chronic back pain, impaired balance disorders, or other forms of chronic pain might benefit from aquatic therapy. Studies show that it can alleviate symptoms and assist patients in regaining strength, flexibility, and joint mobility.

Your physical therapist will assess your requirements and create the best treatment plan. The physician might also recommend certain goals before advising on aquatic therapy sessions that range between 30 and 45 minutes, depending on your therapy plan and diagnosis. You can learn to swim before starting aquatic therapy sessions, but it is not mandatory.

In summary, Medicare Part B will cater to outpatient aquatic therapy and other physical therapy forms believed to be medically essential. It also covers ongoing treatment with no restrictions on the number of sessions you get. On the other hand, Medicare Advantage plans cover outpatient physical therapy, but you should always inquire with your insurance provider for specific coverage details.