Using Insurance for Acupuncture: What You Need to Know
If you’re considering acupuncture but wondering whether your insurance will cover it, you’re not alone. Many patients are unsure how acupuncture benefits work, what’s covered, and how to navigate insurance claims. This guide will answer common questions about using insurance for acupuncture, including coverage eligibility, deductibles, superbills, and tips to maximize your benefits.
Does Insurance Cover Acupuncture?
Acupuncture insurance coverage varies depending on your health plan. Some insurance providers include acupuncture under their policies, while others may only cover specific conditions, such as:
• Chronic pain (e.g., back pain, neck pain)
• Migraines and headaches
• Postoperative nausea
• Osteoarthritis
• Sciatica
To find out if your plan covers acupuncture and if there are limits to what conditions your plan may cover, check your benefits online or call your insurance provider directly. We are currently in-network with Blue Cross Blue Shield of Illinois, Cigna, and Aetna and can verify your insurance coverage before your visit.
How to Check If Your Insurance Covers Acupuncture
1. Log in to Your Insurance Portal or Call Your Insurance Provider – Ask a representative if acupuncture is covered, what conditions are eligible, and whether you need a referral. You can also search “acupuncture” through your online insurance portal.
3. Ask Your Acupuncture Clinic – We offer insurance verification services and can confirm your benefits for you.
Understanding Deductibles and Copays for Acupuncture
Even if your insurance covers acupuncture, you may have out-of-pocket costs, such as:
• Deductible: The amount you must pay before insurance starts covering services. If your plan has a $1,000 deductible and you haven’t met it yet, you’ll pay out of pocket until you reach that amount.
• Copay: A fixed amount (e.g., $20-$50 per visit) you pay for each acupuncture session.
• Coinsurance: A percentage of the service cost you must pay after meeting your deductible (e.g., 20% of each session).
What is a Superbill and How Does It Work?
If we are out-of-network for your plan, you may need to submit a superbill to your insurance for reimbursement. A superbill is a detailed invoice that includes:
• Your diagnosis and treatment codes
• Date of service
• Provider information
• Total cost of treatment
To use a superbill:
1. Pay for your acupuncture session upfront.
2. Request a superbill from us.
3. Submit the superbill to your insurance company.
4. Receive reimbursement (if your plan allows it).
Check your out-of-network benefits to see what percentage of the cost your insurance will cover.
Does Medicare or Medicaid Cover Acupuncture?
• Medicare: Covers acupuncture for chronic low back pain under certain conditions, but not for other conditions. We are currently not in-network with Medicare.
• Medicaid: Coverage varies by state. Some Medicaid programs cover acupuncture for pain management, substance use disorders, and other medical conditions. We are currently not in-network with Medicaid.
Tips for Maximizing Your Acupuncture Insurance Benefits
• Verify benefits before booking an appointment. This prevents unexpected costs. You will receive a link to our insurance eligibility form with confirmation of your new patient appointment.
• Use an in-network provider (if possible) to lower out-of-pocket expenses. We are currently in-network with BCBS IL, Cigna, and Aetna.
• Track your visits to stay within annual session limits. Some plans cap acupuncture visits per year. We can work with you to schedule a treatment plan that would best work with your visit limits.
• Save all superbill receipts for reimbursement or tax deductions.
Find Out if Your Insurance Covers Acupuncture
If you’re unsure about your acupuncture benefits, contact your insurance provider or reach out to us. We can help verify your insurance and explain your options so you can get the care you need.
Need Help with Insurance for Acupuncture?
Book a consultation today and let us guide you through the process!