How About that Insurance Coverage?

"DOES HEALTH INSURANCE PAY FOR ACUPUNCTURE?

Written by Paul Kerzner

Do you have health insurance? Are you considering getting acupuncture? Would you like to know if your health insurance plan will pay for your treatments?

CNN recently reported that nearly 90% of Americans now have some type of health insurance. [Link] This is a significant and substantial increase over the past few years that has been fueled by the Affordable Care Act (also known as Obamacare.)

A lot of acupuncture clinics have received a lot of questions regarding health insurance and whether it covers acupuncture. Given that so many people now have health insurance and are curious to know if it covers acupuncture, we decided to spend some time addressing this topic.

Will my health insurance plan pay for acupuncture treatments? This might appear to be a simple question, but there is no one answer that applies to everyone. Many variables exist among the insurance companies and the plans they offer. There are just too many different health insurance policies that have unique offerings, so while one plan would pay for acupuncture, the next might not.

The first step toward finding out if your health insurance plan covers acupuncture is to contact your insurance provider. You can do this by either calling the phone number on your insurance card or visiting the company’s website. There are three important pieces of information that you should obtain when doing this research:

1) Find out how many acupuncture treatments you are eligible for in a calendar year. 2) Inquire about your deductible (and has it been met/fulfilled). 3) Obtain a list of physical conditions/ailments that are covered when receiving acupuncture.

Each health insurance company has a variety of different plans that provide coverage for different treatment options. It’s important that you obtain the necessary information about your plan and understand what it does and does not cover. Since acupuncture is a relatively recent addition to some health insurance plans, it’s important that you do not automatically assume that it will be covered. If your plan does not have acupuncture coverage, it is important to request that it be added. Health insurance companies need to know that this is a desired addition to their policies.

Do all acupuncturists accept insurance? Not every acupuncturist accepts insurance, so it is important to contact the practitioner before setting up an appointment. It is also strongly advised that you obtain all the necessary information about your insurance plan so you can relay that information to the acupuncturist.

There are some acupuncture practitioners that are “in-network” providers and are listed as such on the insurance company’s website. While it is true that these companies prefer you see these practitioners, you can also visit an “out-of-network” acupuncturist depending on the type of plan you have.

Can I use my flexible spending account to pay for acupuncture? Some companies offer a program called Flexible Spending Accounts. These are special accounts that are used for certain out-of-pocket health care costs. The benefit of using a Flexible Spending Account is that it lowers an individual’s taxable income for the year. Most people who have this account are provided a debit card that can be used to pay for acupuncture treatments. If the card isn’t available, a receipt for services can be provided and then submitted to the flexible spending account administrator for reimbursement."

Does Sacred Lotus Acupuncture accept health insurance? Sacred Lotus Acupuncture does accept insurance. We are in-network with BCBS and Cigna as well as a few other insurance carriers. We also work with patients with whom we are out-of-network providers.

However, please note that because we are in-network with an insurance carrier does not mean that you have acupuncture coverage. Verification of acupuncture benefits must first be done. For this, you may send the necessary information over to our office and we can verify if your particular plan covers acupuncture (i.e. patient name, date of birth, mailing address, name of insurance carrier and plan, Member ID number, group number and phone number on back of the card for the provider to call for benefits). There may also be limitations as to what conditions different carriers and plans will cover for treatment.

We also work with patients who either have HSA/FSA accounts and would like to have a superbill to submit to their accounts for reimbursement purposes. The same is also done for those with whom we do not directly work with (i.e. smaller insurance carriers).

Please give us a call or use the online scheduler to book your appointment.