Health insurance can be confusing. Even though the Affordable Care Act (ACA or Obamacare) made health care coverage more inclusive, there are still some restrictions, which means that all services aren’t covered. And, even though health insurance plans are supposed to provide coverage for services that the ACA requires, every plan is different. Therefore, it’s important to speak to your health insurance carrier to find out exactly what it covers before you schedule any service.
In regard to acupuncture, some health insurance plans do provide coverage and some don’t. However, even if your policy does offer coverage for this treatment, it doesn’t necessarily mean that your acupuncturist will accept your plan, as not all professionals that perform acupuncture will accept insurance. To find out more about acupuncture and health insurance, continue reading
Acupuncture and Health Insurance
Acupuncture is considered a complimentary medical treatment. It’s an ancient Chinese practice that involves stimulating certain points throughout the body, usually with needles, which are penetrated through the skin. Acupuncture is often used to ease pain, usually caused by chronic health conditions. Fibromyalgia, lower back pain, arthritis, and pain that results from cancer treatments are just some of the conditions that are treated with acupuncture.
Does health insurance cover this type of treatment? It depends on your insurance and your health care provider. More and more health insurance plans from a variety of carriers are offering coverage for alternative medical treatments, including acupuncture. As medical professionals are realizing the value that this treatment can provide, they are prescribing acupuncture alongside other more traditional western treatment methods.
Since the benefits of acupuncture are being realized by more and more health care professionals, and because the treatment is more commonly prescribed, many health insurance companies are now offering coverage for this type of treatment. However, with that said, not all carriers offer coverage; and, even those plans that do, the amount of treatment that is covered will vary from policy to policy.
Health Insurance and Acupuncturists
Even if your health insurance carrier does offer coverage for acupuncture, you will also need to check with the professional that provides your care. As mentioned, not all acupuncturists accept health insurance, and those that do may only accept certain plans. Therefore, just because your policy does provide coverage for acupuncture, it doesn’t mean that your acupuncturist will accept your plan.
How to Find out if Your Treatment is Covered
If your healthcare professional recommends acupuncture, the first thing you should do is contact your insurance company to find out if the treatment will be covered. Make sure you ask for specifics. If it is covered, find out what percentage your plan will cover; 100%, 50%, 20%, etc. You will be responsible for covering any portion that your health insurance plan doesn’t cover. Also, you should find out if you will have to pay a copay, as well as what your deductible is, as you will need to meet it before your health insurance kicks in and covers the service. In other words, if your insurer covers acupuncture but you haven’t met your deductible, you will have to meet the limit before your policy will become effective.
Additionally, you are going to want to find out if you have to see an in-network acupuncturist. If you do, find out what providers are in your network; if you see an acupuncturist that isn’t in your network, you’ll likely have to cover the full cost of service out of your own pocket.
Ask for all details in writing, that way you have a hardcopy of your coverage that you can refer to when you are scheduling appointments and filling out forms.
Once you find out the details regarding your health insurance coverage and acupuncture, contact acupuncturists. Ask for recommendations from your insurer if you have to see an in-network doctor. If you don’t have to stay in-network, your insurer can still make recommendations. Either way, make sure you speak with the service provider you are considering working with. To reiterate, not all specialists accept health insurance and the last thing you want to do is schedule an appointment, receive the service, and then find out that it isn’t covered.
The Bottom Line
Acupuncture can be a highly effective alternative treatment for a variety of conditions. Because the benefits of this type of treatment are recognized by more healthcare providers, more insurance companies are offering coverage for this treatment. Nevertheless, it’s important to contact your health insurer to find out the specific details of your plan. It’s also important to speak with your acupuncturist to ensure that they will accept your plan. If your plan doesn’t offer coverage or if it does and you see a professional that doesn’t accept coverage or isn’t in your network, you could end up being responsible for a large bill.
If you require assistance, speak to a reputable insurance agent to find affordable health insurance plans that do provide coverage for acupuncture.