Insurance and Acupuncture

In the United States, acupuncture is a form of complementary or alternative medicine. As such, it still lacks widespread coverage by insurance companies. But as more and more people get relief with acupuncture, demand for the treatment rises. If you’re interested in trying acupuncture, you have several options for paying for it.

Determine Your Health Insurance Benefit

Your insurance coverage is a practical matter. And it may or may not cover acupuncture. Whether is does cover it or not, we provide you with the necessary documents and receipts to help you self-submit claims to your insurance company for coverage. We do not process your insurance claims for you. However, coordinating your care ahead of time with your insurance company could help you receive the most insurance benefits and pay the least out-of-pocket for your care.

Medicare does not cover acupuncture. But the good news is many large private insurers do cover it.

Typically, there are restrictions: Many plans only cover acupuncture while other plans only cover treatments from a licensed acupuncturist. Rest assured, our staff at AHS are licensed and certified with the credentials and experience required by most insurance companies in order to cover your treatment. It is also smart to check prior to treatment so that you understand the number of visits and types of acupuncture covered by your insurer.

Some plans will also cover acupuncture for certain indications, such as various forms of pain, nausea, and migraine headaches. There is scientific evidence that acupuncture may help with these conditions. Again, many plans specify that a licensed doctor must perform the acupuncture treatment.

The bottom line is you need to contact your insurer to learn if your plan covers acupuncture and what the restrictions are. Be sure to ask about copays, deductibles, and whether you need to use a network provider. Also, make sure you know about any limits on the maximum number of treatments you can have.

You will need to self-file with your insurance

Even if your insurance covers acupuncture, you will need to file the claim yourself. Because we do not process any insurance claims on behalf of our clients, we ask that you be prepared to pay for your treatments and file for reimbursement with your plan. We will work with you to make sure you have all the documents and receipts needed to accurately file for reimbursement with your insurer.


Affinity plans may be an option

If your insurance plan doesn’t cover acupuncture, they may still offer an affinity plan. An affinity plan is basically a discount. The provider agrees to offer their services at a discounted rate to members of the plan. Vision plans are an example of an affinity plan. Contact your insurance company to find out more about affinity plans and if your insurer provides one with access to acupuncture treatments.

You can use an HSA (health savings account)

Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) can be used to pay for massage and acupuncture treatments. However, for most HSA and FSA accounts, it requires pre-approval and/or having your physician recommends it with a written prescription. This is an easy process though, and we can walk you through what would be needed as a part of your treatment for a specific issues such as back pain, arthritis, chronic illnesses, hypertension, carpal tunnel syndrome and more. When you come in for your initial consultation and examination, please make sure to let us know what you wish to prepare for paying for treatment with an HSA or FSA account.  For most HSAs AND FSAs that require a prescription and pre-authorization prior to treatment, they often require the following items to be included as a part of the assignment of treatment:

  • Medical necessity: what condition you are treating
  • Frequency: how many sessions per month
  • Duration: how many months

Once you have your prescription and pre-authorization, let us know what it says and then file it away with your records in case you are ever asked to back up your expense. We would suggest that you use a payment method such as an HSA or FSA account debit card or a personal credit card so that you have a specific and documented receipt for the exact payment amount for your treatment.

Please note that gratuity is not considered part of the cost and so does not qualify as a qualifying expense.

Advanced Healthcare Solutions is committed to making you feel secure and confident in your health and treatment options.

HSA and FSA payment options make our treatments more accessible, which means we can assist more people in becoming healthier and introduce new clients to the benefits of acupuncture and other holistic therapies.

Talk with your employee benefits manager or tax advisor to see whether an FSA or HSA is right for you. If so, check with your HSA account administrator to find out what documentation you need for reimbursement.