Is Acupuncture Covered by Insurance?
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Many private health insurance companies cover acupuncture, and in 2020, government-funded health insurance programs like Medicaid and Medicare jumped on the bandwagon. If you suffer from the following health conditions, you may be interested in seeking acupuncture for pain relief:
- Neck pain
- Back pain
- Dental pain
- Tennis elbow
- Menstrual cramps
- Respiratory disorders
- Stress and anxiety
- Parkinson's disease
What Are the Insurance Requirements for Acupuncture?
Insurance requirements for acupuncture vary from policy to policy, although at minimum your insurance carrier most likely requires that you seek services from a licensed health practitioner in your state. You may also have a limit to the number of visits you are eligible for within a calendar year. Your insurance carrier may also only cover acupuncture treatment for specific issues like chronic lower back pain. If you're unsure about what your insurance company will cover, you can contact the number on your insurance card to determine if they cover acupuncture and what that coverage entails. A few questions you might want to keep in mind include:
- What is the number of treatments included in my coverage?
- How much will insurance pay?
- What is my co-pay for an in-network acupuncturist?
- What is my co-pay for an out-of-network acupuncturist?
- Will I need a referral from a doctor first?
- Do I have to meet my deductible?
- Is acupuncture only approved for certain pain treatments?
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What Types of Health Insurance Companies Cover Acupuncture?
The vast majority of health insurance plans cover acupuncture, including private health plans and employer-offered health insurance companies. These include well-known insurance carriers like:
- Aetna: Acupuncture was added as standard therapy in 2022 for chronic headaches, chronic lower back pain, neck pain, nausea, osteoarthritis and more.
- Blue Cross Blue Shield: Members get 12 covered acupuncture sessions per year from practitioners who are within or outside their network. Beyond these sessions, you get a 30% discount for further treatment.
- Banner Health: Members can choose from multiple forms of integrative therapy and traditional medicine to heal pain and health issues.
- United Healthcare: Employers may offer supplemental benefits to their workers, including acupuncture services.
- Kaiser Permanente: Members can get up to 20 acupuncture visits per year with a $15 copay.
- Cigna: Cigna only covers acupuncture services for limited conditions like pregnancy-related nausea and migraines — guidelines are strict and very specific.
- Health Net: Health Net has teamed with American Specialty Health Group to provide members with flexible acupuncture coverage within their directory. Members can add this coverage to their current health plan, and do not need to be referred to see an acupuncturist.
Acupuncture Coverage Required in Some States
According to the CDC, non-drug treatments like chiropractic care, physical therapy and acupuncture are included as part of the efforts to curb opioid abuse. States are also adding acupuncture as an essential pain relief therapy that must be covered by health insurance. For example, as of 2022, Oregon is required to cover 12 acupuncture sessions per year, and in 2023 Colorado will start covering six acupuncture sessions per year. Government-sourced health plans like the VA, Medicaid and Medicare also recently started adding acupuncture to their list of covered benefits as of 2020.
How To Bill an Insurance Company for Acupuncture
Depending on your health plan, it may be necessary for patients to either pay the practitioners out-of-pocket and seek reimbursement from their insurance later, or to pay a copay with each visit. Billing requirements and guidelines will vary from provider to provider, so it's important to ask before you make your first appointment.
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Are Referrals Required To See an Acupuncturist?
Not all insurance plans require a referral to visit an acupuncturist, but some do. Most HMO insurance plans require members to get a referral from their primary care doctor before they can see a specialist, for example, but perhaps not so for acupuncture. You will need to contact your health plan to ensure that you understand the guidelines.
Insurance Coverage for Pain Relief
Many health plans are designed to meet your budget and needs — but it can be overwhelming trying to look at them side-by-side. The right insurance policy includes preventive health care and progressive non-drug therapies along with resources and tools to keep you and your family healthy and safe. SmartFinancial can help you find free insurance quotes in your area so you can get the right coverage for you. Just enter your zip code below and answer a few brief questions to compare rates right away.