Decompression therapy is a treatment that helps reduce pain from pressure on nerves by stretching out the affected area, such as the spine or the knees. It can be done by manual traction, devices, or surgery.
Decompression Therapy is not covered by insurance, however, its cost is decreasing. Physical therapy and chiropractic care may be reimbursed as alternatives to decompression therapy. Your doctor and insurance company may help you decide.
In this article, we will explore these factors and provide some tips on how to determine if your insurance covers decompression therapy.
Understanding Insurance Coverage for Decompression Therapy
The Role Of Health Insurance In Covering Decompression Therapy
Your health insurance contract covers part or all of your medical expenditures. Your plan may require a deductible, co-payment, or co-insurance for some services and treatments.
Decompression treatment is sometimes covered by health insurance. Decompression therapy for herniated discs, spinal stenosis, and sciatica is covered by certain insurance companies. In some situations, your insurance may fund decompression treatment.
However, some insurance providers see decompression therapy as an experimental or exploratory treatment. These situations may not be covered by insurance.
Differences In Coverage Among Insurance Providers
There is no standard policy or guideline for insurance coverage of decompression therapy. Different insurance providers may have different criteria and requirements for covering decompression therapy.
Some factors that may affect your coverage include:
- The type of decompression therapy: Decompression treatment includes mechanical traction, inversion therapy, and NSD. Some insurers cover just one kind.
- The diagnosis: Your insurance provider may require a specific diagnosis from your doctor to justify the need for decompression therapy. For example, some insurance providers may only cover decompression therapy for herniated discs but not for degenerative disc disease.
- The treatment plan: Your insurance provider may require a detailed treatment plan from your doctor that outlines the goals, frequency, duration, and expected outcomes of decompression therapy. For example, some insurance providers may only cover a limited number of sessions or a certain period of time for decompression therapy.
- The provider: Your insurance company may only cover decompression treatment if a professional physical therapist or chiropractor does it. Some insurance companies provide decompression treatment savings via recommended providers or networks.
How to Determine if Your Insurance Covers Decompression Therapy?
Contacting Your Insurance Provider To Inquire About Coverage
Contacting your insurance provider about your plan and scenario is the best method to see whether decompression treatment is covered. Your insurance card’s customer support number or website might provide extra information.
Some questions you may want to ask your insurance provider include:
- Does my plan cover decompression therapy?
- What type of decompression therapy is covered?
- What diagnosis do I need to qualify for coverage?
- What treatment plan do I need to follow?
- How many sessions or how long can I receive decompression therapy?
- How much will I have to pay out-of-pocket for decompression therapy?
- Which providers can I see for decompression therapy?
- Do I need a referral or prior authorization for decompression therapy?
Asking Your Healthcare Provider For Assistance
You may also ask your doctor whether your insurance supports decompression therapy. Your healthcare professional may be able to guide you through the insurance process.
Some ways your healthcare provider can help you include:
- Providing you with a diagnosis and a treatment plan that supports the need for decompression therapy
- Submitting claims or paperwork to your insurance provider on your behalf
- Negotiating with your insurance provider for lower rates or better coverage
- Offering alternative payment options or discounts if your insurance does not cover decompression therapy
Do all insurance companies cover decompression therapy?
No, not all insurance companies cover decompression therapy. Different insurance companies may have different policies and criteria for covering decompression therapy. Some may cover it as a medically necessary treatment, while others may not cover it at all. It is important to check with your insurance provider before starting decompression therapy to avoid unexpected costs or denials.
Is decompression therapy worth it?
Decompression therapy may help chronic or severe nerve compression pain. Decompression treatment relieves nerve pressure and repositions joints to enhance mobility, function, and discomfort.
If your discomfort is minimal or transitory, decompression treatment may not be worth it. If you have osteoporosis, fractures, tumors, infections, or spinal instability, decompression may not be worth it.
Decompression treatment depends on your health, objectives, preferences, and budget. Before commencing decompression treatment, discuss the pros and downsides with your doctor and insurance provider.
What is the success rate of spinal decompression?
Spinal decompression works in 71% to 89% of patients, according to most research. Spinal decompression helped 71% of 778 herniated disc patients in a Journal of Neurological Research study.
Another American Journal of Pain Management research indicated that 86% of herniated disc patients had “good to excellent” relief following spinal decompression.
Spinal decompression is temporary. It relieves pain for months or years, but symptoms may recur. Spinal decompression may temporarily relieve pain and enhance function.
What are the potential out-of-pocket costs of decompression therapy?
Decompression treatment expenses vary on the kind, insurance coverage, provider, and location. Decompression treatment sessions cost $30–$200. Decompression treatment costs $600–$6,000 or more.
If your insurance does not cover decompression treatment or just covers a fraction of it, you may have to pay for it yourself. Decompression therapy-related consultations, examinations, x-rays, braces, and supplements may cost extra.
To reduce your out-of-pocket costs for decompression therapy, you may want to:
- Compare prices among different providers and locations
- Ask for discounts or payment plans from your provider
- Use a health savings account (HSA) or a flexible spending account (FSA) to pay for decompression therapy
- Seek financial assistance from charitable organizations or foundations
