Pain management

Medicare Part B (Medical Insurance)

helps pay for these services that may help you manage your pain and related issues:

Behavioral health integration services
Physical therapy
Occupational therapy
Manual manipulation of the spine if medically necessary to correct a subluxation
Alcohol misuse screenings & counseling
Depression screenings
Acupuncture for chronic low back pain

Medicare Drug Coverage (Part D)

helps pay for:

Medication Therapy Management programs for complex health needs.
Opioid pain medication. Prescription opioids, like hydrocodone (Vicodin®), oxycodone (OxyContin®), morphine, codeine, and fentanyl can be used to help relieve severe pain. Some Medicare plans have certain coverage rules to help you use opioids safely. Get more information on drug plan coverage rules.

Your costs in Original Medicare

For most pain management services, you pay 20% of the Medicare-Approved Amount for visits to your doctor or other health care provider to diagnose or treat your condition. The Part B deductible [glossary] applies.
If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital.
You pay nothing for a yearly depression screening if your doctor or health care provider accepts assignment.

Note:

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

Other insurance you may have
How much your doctor charges
If your doctor accepts assignment
The type of facility
Where you get your test, item, or service

What it is

There are many ways to manage pain safely and effectively. While prescription pain medications covered under Medicare prescription drug coverage (Part D) may be effective at treating certain types of pain, especially during short-term use, you might be able to take other medications or do other things to help effectively manage your pain with less risk long term. Talk with your doctor about all your pain treatment options.

Things to know

There may be other ways to manage your pain. Your doctor may recommend treatment options that Medicare doesn’t cover, like massage therapy.

If this happens, or if your doctor or other health care provider recommends you get services more often than Medicare covers, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and if Medicare will pay for them.