Medicare Part B may cover aquatic therapy if it is medically necessary. “Medically necessary” means the therapy improves or prevents the deterioration of a person’s condition.
Aquatic therapy involves performing specific exercises in a water environment. This may benefit people who require lower-impact exercise that does not strain the joints excessively.
Medicare may cover aquatic therapy under specific circumstances. These include when the therapy is medically beneficial and performed with the supervision of a skilled therapist registered with Medicare.
This article looks at Medicare for aquatic therapy, what aquatic therapy involves, and the benefits of the therapy. It also looks at who should avoid aquatic therapy and compares it to hydrotherapy.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Aquatic therapy is a type of physical therapy, which Medicare Part B covers under certain circumstances.
According to Medicare, if a healthcare professional specifies that a person needs physical therapy, Part B can help pay for it. This may include therapy to improve or restore movement following an illness, injury, or surgery or to improve or maintain current function.
For aquatic therapy to qualify as medically necessary, documentation from a healthcare professional must support its need for more than eight sessions. Supporting documentation can include the results of medical examinations and a medical history showing pain, loss of balance, function, mobility, strength, or coordination.
The documentation must also include justification for a water environment, outline the specific exercises a person requires and their purpose, and justify the need for a skilled therapist.
Medicare does not cover aquatic or other physical therapies for general health improvement, such as overall fitness and flexibility. The therapy must be medically necessary for improvement, maintenance, or rehabilitation relating to a health condition.
While there is no limit to how much Medicare pays for medically necessary outpatient physical therapy annually, there may be other costs to consider. These include:
- the deductible relating to Part B
- 20% of the Medicare-approved amount
- prescription medication, which falls under Medicare Part D
- more or different services than Medicare covers
Aquatic therapy is a type of physical therapy that involves performing specific exercises in a water environment, such as a heated pool.
The exercises use water buoyancy and resistance to gently build strength and improve mobility and balance without straining the joints.
The exercises a person performs can depend on their health conditions and capabilities. A physical therapist will tailor an exercise program to the individual’s health needs and goals.
A physical therapist may also balance aquatic therapy with land-based exercises.
Aquatic therapy provides the benefits of exercise while protecting the joints from excessive stress. It may help reduce pain or improve mobility, strength, muscle tone, and circulation.
Aquatic therapy may also help provide rehabilitation following illness, surgery, or injury and improve a person’s ability to perform daily activities.
Due to its low impact on joints, aquatic therapy may be beneficial for some symptoms of musculoskeletal and neurological disorders, such as:
- arthritis
- back pain
- multiple sclerosis
- balance disorders
- spinal cord injuries or disorders
- athletic injuries
- postorthopedic surgery
Who should not do aquatic therapy?
A person needs to speak with a doctor or physical therapist before trying aquatic therapy if they have any of the following:
- open wounds
- skin infections
- chlorine allergy
- an upset stomach or stomach virus
- incontinence
- a seizure disorder
- breathing difficulties
Some people use the terms “aquatic therapy” and “hydrotherapy” interchangeably. However, while aquatic therapy refers to physical therapy exercises in water, hydrotherapy refers to water therapy in any form.
Other types of hydrotherapy include:
- baths and showers for stress relief and relaxation
- hydromassage, which uses water pressure to massage areas of the body to improve circulation, ease pain, and promote relaxation
- immersion therapies in warm or cold water to relieve pain, such as sciatica
- wraps and compressions with hot or cold water to provide targeted pain and inflammation relief
- sitz baths, which involve sitting in shallow water, sometimes with a compress
Individuals may be able to perform some types of hydrotherapy at home, in a public water environment, or in a spa without the assistance of a skilled therapist. This could make hydrotherapy more affordable and accessible.
However, aquatic therapy may be more beneficial if a person has a chronic or ongoing condition that requires physical therapy.
A person may want to consult a healthcare professional about the benefits of aquatic therapy versus other types of hydrotherapy for their condition.
Aquatic therapy is a type of physical therapy that involves performing specific exercises in water. Medicare may cover aquatic therapy if a healthcare professional demonstrates that it is medically necessary.
Aquatic therapy can help provide the benefits of physical therapy exercise, such as improving strength, balance, and mobility, while minimizing joint stress. This makes it especially beneficial for people with musculoskeletal and neurological disorders.
A person can discuss aquatic therapy and its potential benefits with a healthcare professional and their health insurance provider to determine if coverage is possible.
