Does Insurance Cover Acupuncture?
Health Insurance Coverage for Acupuncture
Most private health insurance plans have covered acupuncture for years now. And in 2020, government-run insurance programs like Medicare and Medicaid followed suit, adding acupuncture coverage to their list of benefits.
Health insurers decided to provide acupuncture benefits for the same reason they provide all benefits: Acupuncture saves them money and is an effective way to treat a variety of health issues.
Over the past two decades, medical insurance companies have moved more and more toward a holistic approach to overall wellness. It’s why most insurers now cover items like fitness programs and smoking cessation. People who exercise and don’t smoke have fewer health problems than people who do. Therefore, they are cheaper to insure.
Acupuncture is recognized as a safe alternative to treat a variety of issues, including:
The types of acupuncture treatments covered by your insurance vary according to your policy. Check your health insurance plan’s benefits to understand how your plan covers acupuncture. Or, call our office and we’ll work with you to verify your coverage.
What Are Insurance Requirements for Acupuncture?
Acupuncture guidelines vary from plan to plan. At a minimum, though, your insurance provider likely requires you to visit an acupuncturist who is licensed to practice in your state. In addition, you are probably limited to a certain number of visits in a calendar year. Your plan may also only cover acupuncture for specific issues, such as chronic low back pain.
Again, guidelines vary according to plan and provider.
What Types of Health Insurance Cover Acupuncture?
Private insurance plans, like the group health plans many people have through an employer, have covered acupuncture for years. This includes most of the bigger insurance companies:
- Banner Health
- Blue Cross Blue Shield
- Health Net
- United Healthcare
In 2020, some government-run insurance programs also added acupuncture to their list of covered benefits. This includes:
- Medicare: Provides health insurance to American citizens age 65 and older as well as those who have certain medical conditions or who collect Social Security disability benefits for at least 24 months.
- Veteran’s Administration: The VA provides healthcare to the millions of active duty and retired members of the U.S. armed services.
In addition, federal employees now receive acupuncture benefits under their medical insurance.
As per an announcement from the Centers for Medicare & Medicaid Services (CMS), government programs began covering both acupuncture and chiropractic care to help fight the opiod epidemic. They recognize that acupuncture is a safe, effective way to treat chronic pain and can help patients avoid highly addictive pain pills.
What Does Medicare Cover?
Medicare limits acupuncture coverage to 12 visits over a 90-day period to treat chronic, low back pain. CMS defines “chronic low back pain” as lasting for at least 12 weeks and not being caused by surgery, pregnancy, or disease.
Acupuncture coverage is part of your Medicare Part B benefits. That means you’re also covered if you have a Medicare Advantage plan (instead of Original Medicare).
Full details are available on Medicare.gov.
Quote from David LeGar Regarding Medicare Insurance & Acupuncture:
“While it’s true that Medicare covers up to 12 visits a year for lower back pain, with the possibility of 8 additional visits if treatment is effective, the reality is a bit more complex. Medicare currently doesn’t employ acupuncturists, so we can’t directly bill them for our services. This isn’t an issue with our practice; it’s a limitation within the Medicare system itself. The reason for this is that there are still 3 states in the U.S. that haven’t officially recognized acupuncture as a medical practice. Since Medicare is a federal program, it requires all 50 states, plus D.C., to accept acupuncture as a valid treatment before they will employ acupuncturists. So, while the service is technically available, there are no acupuncturists to provide it under Medicare until those remaining states update their regulations.”
Do I Need a Referral to See an Acupuncturist?
Whether you need a referral to visit an acupuncturist depends on your insurance plan. For example, most HMO plans require enrollees to visit their primary care doctor before seeing any specialist. Check with your plan provider to make sure you understand the guidelines.
Does Accurate Acupuncture Accept Insurance?
Yes, we accept most major insurance. We are an in-network provider for United Healthcare, Aetna, and Healthnet. We also accept Blue Cross Blue Shield, Cigna, and Banner Health Choice Plus.
Call us at 928-274-1980 and we’ll help verify your coverage. And if you have a Medicare Supplement plan, please let us know to ensure proper billing.