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If you’re looking to get shock wave therapy and want to know if Medicare will cover it, the answer probably is no. However, there’s more to the story which we’ll cover below.
Whether you’re struggling with chronic pain or a specific medical condition, Shock Wave Therapy might be on your radar. Stick around to learn what this treatment involves, who can benefit from it, and what the science says about its effectiveness.
Ready to dive in? Let’s get started.
In most cases, the answer is no. Medicare will not cover the cost of shock wave therapy.
With that said, there may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your shock wave therapy.
Original Medicare (consisting of Part A and Part B) does not provide coverage for shock wave therapy unless it is performed for a medically necessary reason.
If the purpose of shock wave therapy is to preserve life and treat a serious health condition, then it is possible you may be able to receive coverage.
In most cases, however, if you choose to try out Extracorporeal shock wave therapy (ESWT), you will have to pay 100 percent of the costs. Again, Medicare does not provide coverage for procedures if they are done for non-medically necessary reasons.
But what about other Medicare plans?
Similarly, Medicare Advantage plans (Medicare Part C) also do not cover shock wave therapy. These plans cover the same things Original Medicare covers but goes above and beyond to provide coverage for some treatments Original Medicare does not cover.
Exactly what a Medicare Advantage plan covers and how much your out-of-pocket costs are will vary depending on your plan.
The average cost of shockwave therapy is $300. However, the costs of shock wave therapy may either be higher or lower than that. However, it will usually fall between $250 and $400.
Medicare usually won’t pay for shock wave therapy, so you’ll have to cover all the costs yourself. This includes not just the treatment but also any extra fees like copays and deductibles.
On top of the treatment cost, you might have other fees. These can change based on your Medicare plan and may include:
There are some programs that might help you pay for shock wave therapy. These can be from your state, local community, or health insurance company.
You could also look at different insurance plans, like private health insurance or disability insurance, to see if they cover shock wave therapy. But make sure to check the details of your plan first.
Several resources can help you with the costs:
Shock wave therapy is a non-surgical, non-anesthetic medical treatment. It employs high-energy sound waves to address issues like scar tissue and calcified deposits within soft tissues.
A device generates a high-pressure air or water pulse to create shock waves. These waves are directed at the targeted area through a handpiece.
The waves induce minor damage to the tissue, initiating the body’s natural healing mechanisms, including the release of substances that promote tissue repair.
This therapy is utilized for various medical conditions, including:
Advantages of shock wave therapy include its non-invasive nature, effectiveness for multiple conditions, and low risk of side effects. Potential risks involve:
Shock Wave Therapy | Acoustic Wave Therapy | |
---|---|---|
Technique | Focuses high-pressure sound waves on a specific body part. | Uses softer sound waves over a larger area. |
Uses | Mainly treats chronic joint pain like in the heel, knee, and shoulder. | Treats a broader range of issues, like plantar fasciitis, tendinitis, and even erectile dysfunction. |
Results | Generally more effective for chronic conditions, giving more noticeable relief. | Also works but may give less dramatic results. |
To know which treatment suits you best, consult your doctor. They can review your symptoms and suggest the most fitting option.
ESWT can be used regularly to treat many physical conditions.
ESWT is a type of therapy that relieves pain in the areas treated. But how does it do this exactly?
A lot of research suggests that ESWT relieves pain in the following ways:
The short answer to that is no. Other well-known health insurance companies such as Aetna, Cigna, United Healthcare, and AARP do not provide coverage for shock wave therapy for treating erectile dysfunction.
This article talks about if Medicare pays for Shock Wave Therapy, a treatment some people get for long-term health problems. We showed what Medicare will and won’t pay for, and shared other ways to help pay for it. It’s important to know if Medicare covers this so you can plan your healthcare and know how much you might have to pay.
If you’re thinking about getting this treatment, this info can help you decide and know how to save money for it.
We hope this helps you! If you have your own story or questions about using Medicare for Shock Wave Therapy, please share. Your thoughts can help others like you. You can also read more on our website.
Don’t use Shockwave therapy if you: are pregnant, have problems with blood clotting, are taking blood thinners, got a steroid shot in the last 6 weeks, have a pacemaker or have tumors where you’d get the treatment.
Shockwave therapy uses strong sound waves to help heal body tissues. TENS uses small electric shocks delivered through sticky pads on the skin. There are over 3000 studies on shockwave therapy, and it’s being researched all the time. Unlike TENS, which just treats the feeling of pain, shockwave aims to fix what’s causing the pain.
Most people feel better right away and usually need only 2 or 3 sessions over 6 to 12 weeks to fully heal. The great thing about this method is that if it’s going to help, you’ll likely feel better right after the first session.
Medicare doesn’t cover the cost of shock wave therapy for foot pain caused by plantar fasciitis. They don’t consider this treatment medically needed or reasonable for muscle and bone conditions like plantar fasciitis.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage. Always double-check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Also, you can check out other articles in this series such as does Medicare cover pelvic floor therapy and Medicare coverage for IVIG for CIDP.