Finding Ways To Get Insurance Coverage of Acupuncture
Insurance coverage for acupuncture
A certified provider’s referral may be key for people who have difficulty opening insurance coverage for acupuncture, experts say.
Acupuncture is certainly a mixed bag when it comes to whether insurers will cover it or not. Some insurers do. Some don’t.
Regardless, experts say, having a doctor’s referral may be a way to open the door for patients.
“Your doctor may need to refer you or contact your insurance company explaining why a non-drug treatment is medically necessary,” according to health.com
Work to do
It may take a little more work for people who use acupuncture to get insurance coverage, but having records also is important.
Experts advise keeping a copy of the prescription or a doctor’s note to prove that the treatment is needed for an ailment, such as pain.
Even if you can’t get a prescription from a physician you should get a detailed receipt whenever you pay out of pocket for an alternative treatment.
That will increase your chances of being reimbursed.
When patients go to the acupuncturist, they should also check how many treatments they get, and find out exactly what the insurance company will pay for.
In addition, they should ask what is the normal co-pay for acupuncture from a provider (which would be a patient’s out of pocket costs), or whether the cost for practitioners may be considered out of their network, or whether a referral is needed, health.com says.
Also, it may be important to contact an employer’s wellness program and ask whether it has negotiated reduced rates for therapies not covered by insurance.
It is important to remember that acupuncture is a form of complementary or alternative medicine.
For instance, chiropractic care or physical therapy may be covered, so questions may be posted, such as “why not acupuncture therapy?”
There is some evidence that acupuncture may help alleviate conditions such as pain, nausea and migraine headaches, studies have shown.
Patients can speak to insurers and here are some ways they may convince insurers to cover acupuncture, health.com says.
- Make a good case that the treatment is a medical necessity
- Get a prescription for acupuncture. (A doctor may be asked to write one that includes information such as diagnosis
- How long treatment is needed
- Try to convince insurers that covering alternative treatments may save them money, as opposed to conventional treatments
- If the insurance plan doesn’t cover acupuncture one of the best things you can do is to write a letter to the insurance company and your human resources representative if you receive insurance benefits through your employer
- If an insurer says its not covering acupuncture, it also may be wise to file an appeal
- Some insurers will give an OK right away if prescribed by a physician
Some insurers cover acupuncture when it is used instead of anesthesia.
Often, a licensed doctor is needed to perform the work.
In some cases, doctors aren’t required for coverage such as the California Medicaid program or Blue Shield of California.
Talk to acupuncturist
“If your insurance company places restrictions on the acupuncture coverage on your policy, please talk to your acupuncturist.
They may be able to help you navigate the confusing world of insurance and acupuncture, and can possibly help you get coverage for additional treatments,” according to the AOMA Graduate School of Integrative Medicine.
Sarah Bentley. 5 Tips To Get Your Insurance Company to Pay for Acupuncture. AOMA Blog. 2013. http://blog.aoma.edu/blog/bid/223378/5-Tips-to-Get-Your-Insurance-Company-to-Pay-for-Acupuncture
Jeanne Lee. How to Get Your Medical Insurer to Cover Alternative Medicine Treatments. 2012. Retrieved from:
QuoteWizardbylendingtree. Your Guide to Alternative Medicine and Health Insurance. Retrieved from: https://quotewizard.com/health-insurance/complementary-and-alternative-medicine-and-health-insurance
Finder. Health insurance for acupuncture. Retrieved from: https://www.finder.com.au/health-insurance-for-acupuncture
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