Insurance coverage for acupuncture varies from state to state and plan to plan. Some plans may have limited acupuncture coverage others no coverage at all. Contact your insurance provider to learn whether acupuncture is covered. Here are a few questions to ask:
- Will my plan cover acupuncture for my health problem? (some plans are very limited on the conditions they will cover)
- How many visits per calendar year? (The will tell you a maximum upper limit. Word of caution — that does not necessarily mean the company will pay for that many visits.)
- Do I need a referral from a physician?
- May I choose my own acupuncturist or is there a provider list I have to choose from?
- Do I have a co-pay or co-insurance?
- Do I have a deductible? If yes, has it been met?
Regarding particular insurance carriers:
VA Community Care: Currently we are a Community Care Provider for the Lexington VAMC. For more information check out the information on our Acupuncture for Veterans page.
United Healthcare: Because we are credentialed with United/Optum through the Community Care Program with the VA, we are recognized by United. Your plan will determine whether our office is considered in-network.
Humana: We are not credentialed with Humana and are considered an out-of-network provider at this time. Payment in full will be due at the time of services.
Cigna: Unfortunately, we terminated our contract with American Specialty Health (ASH), which manages Cigna acupuncture claims, on April 12, 2022. We are no longer a network provider and payment in full will be due at the time of services.
Anthem/BCBS: Unfortunately,since plans are managed by American Specialty Health (ASH), we cannot accept Anthem/BCBS. Our contract with ASH ended on April 12, 2022. We are no longer a network provider and payment in full will be due at the time of services. Some plans do cover acupuncture, but they generally cover a very limited set of conditions.
Medicare: The only condition currently covered by Medicare is low back pain. No other health conditions are covered at this time. There is a bill with bipartisan co-sponsorship by California Representative Judy Chu and Pennsylvania Representative Brian Fitzpatrick (HR4803: Acupuncture for Our Seniors Act of 2023) that seeks to expand coverage for acupuncture. We encourage you to contact your congressional representatives and senators to encourage them to support the bill.
Medicaid: Unfortunately, Medicaid does not cover acupuncture at this time. Once the Center for Medicare and Medicaid Services recognizes acupuncturists as providers (see Medicare bill mentioned above), this may change. Like those with Medicare coverage, we encourage you to contact you congressional representatives and senators to encourage them to expand coverage to include acupuncture.
If you would like to know if your insurance will cover acupuncture treatments, we can check with the company using the information on the front and back of your insurance card. We can provide a statement (Superbill) with the relevant information for submitting to your insurance company so that you may be reimbursed if your plan does cover acupuncture. Each plan is different, so check with your insurance company first to find out whether your plan covers acupuncture.
