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Is Massage Covered Under Michigan No-Fault Insurance?

Is Massage Covered Under Michigan No-Fault Insurance?

Recovering from a car accident injury can be a long and grueling process. Depending on the severity of an injury, it can sometimes take years to fully recover. In many instances, past injured drivers require regular forms of physical therapy and other methods of treatment like massage therapy just to feel like themselves. Unfortunately, however, after the No-Fault Insurance reform of 2019, insurance companies in Michigan have begun putting cases through a Utilization Review.

This review determines which procedures the insurance deems as critical to an injury victim’s recovery, and therefore either willing or unwilling to pay for such expenses. Of course, insurance companies want to pay as little money as possible, so they look to cut anything they can. Unfortunately, these reviews have proven to be detrimental to massage therapy patients, and individuals in need aren’t receiving the financial support they should be from insurance companies. So, this begs the question, is massage therapy covered under the Michigan No-Fault Insurance law?

Understanding Michigan No-Fault Insurance

As a “No-Fault State,” according to Michigan.gov, Michigan drivers who have the legally required no-fault insurance can receive compensation after suffering a car accident injury, despite who was at fault. This is drastically different from most other states in which injury victims must prove the other driver’s fault and then force them to pay. As described by accident attorneys at Haque Legal, after being injured, under the No-Fault Insurance law, your own auto insurance company will then be responsible for providing benefits to help you recover from the accident by paying for medical bills, lost wages, and more.

What Changed in 2019?

In 2019, as part of Michigan’s new auto no-fault insurance law, healthcare providers may file an appeal when an insurer has made a determination that the care they have provided to an accident victim is excessive. In turn, insurance companies have begun putting benefits under review and making cuts to injury victims’ payments after determining by their own standards whether a victim’s healing treatment is necessary. As a result, the practice of massage therapy, which has been a proven and helpful medical procedure, is a medical practice insurance companies have come down hard on.

Can Massage Therapy be Covered by No-Fault Insurance?

With the changes to the Michigan No-Fault insurance law, many people who desperately need the relief massage therapy provides are losing their benefits following a review. This puts patients in the unfair position to either decide to stop being treated and live in pain or pay out-of-pocket, which some can’t afford to do. Yet, there is hope. There are instances in which massage therapy expenses can be covered by a victim’s no-fault auto insurance company, but there are requirements that must be met. 

These requirements are:

  • The massage therapy was “reasonably necessary” to the auto accident victim’s rehabilitation. (MCL 500.3107(1)(a))
  • The massage therapy charges were “reasonable.” (MCL 500.3107(1)(a))
  • The massage therapy services were “lawfully render[ed]” (MCL 500.3157), which means the therapist is a licensed massage therapist under Michigan’s Public Health Code.

Therefore, if your massage therapy covers these necessary requirements, you should be able to have them covered by Michigan no-fault insurance. When people are told that their massage therapy will no longer be provided for, many give up and assume that they can’t prove an insurance company otherwise. However, that shouldn’t be the end of it. If your treatment is denied, you should seek out legal help and consider a lawsuit against the insurance provider. As long as you can prove the previously mentioned requirements, you and your legal counsel have a strong case to ensure that you still receive benefits.

 

Special thanks to Jackson Ruby of Haque Legal for the article contribution.

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