Will Insurance cover my Acupuncture treatments?
There are a number of different insurance plans out there and their coverage details change constantly. It is your responsibility to call your insurance carrier to ask if they will pay for Acupuncture. Here is some general information to help you when you make these inquiries.
Auto Accident Claims
NOTE: This means that we may not know that the funds are exhausted until after you have had several treatments beyond the last covered treatment. Once the lump sum available for medical expenses is exhausted, the patient must pay out of pocket for any further treatments and pursue repayment thru legal channels. You will receive paperwork from our office explaining this process in more detail if you are here under an Auto Accident Claim.
Typically, WC will only approve up to 16 treatments. Once further treatments are denied, the patient must pay out of pocket for any further treatments and pursue repayment through legal channels.
Flexible Spending Accounts & Medical Savings Account
Please bring your card to your first visit so that we can make a copy of it for our records. Many BCBS plans from other states do offer coverage for Acupuncture. However, since we are considered an “out of network” provider, they will not send payment to our office. Instead they will send payment to you. For this reason we require that patients in this category pay the full charge for the treatment at the time of the visit. We will provide you with a computer generated receipt which you can submit for reimbursement.
Other Insurance Plans
- Is there coverage for acupuncture?
- If yes, are there any restrictions in terms of diagnosis, provider, or place of service?
- Is there any precertification or referral required?
- Is there a limit to the number of treatments per diagnosis or per calendar year?
- Is there a co-pay and/or coinsurance amount I am required to pay?
- Do I have to meet my deductible first before coverage begins?
- If there is no coverage, are there any discounts* that you are eligible for through your plan?
*Many Insurance plans offer discounts thru some sort of affinity program. This is an arrangement that the insurance company has with certain providers to offer their members treatments at a discounted price. This is not the same as coverage. You will be required to pay the discounted rate at the time of the visit. Please note that we do not participate with all the discount plans offered by insurance companies.
Be sure to bring your insurance card with you to your first visit if you think you might have coverage or a discount thru your plan.
If you have any questions regarding any insurance related issues, please call the practice manager Barb April: (413) 366-5601.