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Acupuncture is a covered benefit under the Affordable Care Act aka "Obamacare" in California.
Effective 1/1/15, a handful of states now have mandatory acupuncture benefits! California is the only state to specify that acupuncture be provided on an unlimited basis for pain management. The vast majority of California's 38 million residents now have a basic level of acupuncture coverage.
Although we don't see this as a green light for unlimited coverage (due to authorization requirements, records review for medical necessity, etc.) this is a huge step in the right direction for the acupuncture profession. Additionally, there can be no discrimination that allows acupuncture by an MD only (a previous exception we sometimes experienced) -if acupuncture is a covered benefit, it must be paid to a licensed acupuncturist. (section 2706 and 2707 of the ACA).
What does this mean for you? ANY and ALL plans in the State of California must now cover acupuncture. The ONLY possible exception are plans that were "grandfathered" in:
A grandfathered plan is any coverage provided by a group health plan or a health insurance issuer in which an individual was enrolled on or before March 23, 2010. Additionally, employer funded plans can choose the benefits they offer and exclude acupuncture. Employer plans based in other states (Blue Cross of Illinois, for example) are subject to the mandated benefits for THAT state, not California. If acupuncture isn't mandated, you may not have the coverage.
Many insurance companies now cover acupuncture for the treatment of common disorders. Since consumer demand for natural healthcare has increased in recent years, more and more insurance companies are providing benefits. We participate in many insurance plans and have an insurance billing consultant on staff to handle your billing needs. The following is a list of some of the insurance companies that cover acupuncture. To see if your insurance has coverage, please call the office and we will gladly check your individual benefits.
Effective 1/1/15, a handful of states now have mandatory acupuncture benefits! California is the only state to specify that acupuncture be provided on an unlimited basis for pain management. The vast majority of California's 38 million residents now have a basic level of acupuncture coverage.
Although we don't see this as a green light for unlimited coverage (due to authorization requirements, records review for medical necessity, etc.) this is a huge step in the right direction for the acupuncture profession. Additionally, there can be no discrimination that allows acupuncture by an MD only (a previous exception we sometimes experienced) -if acupuncture is a covered benefit, it must be paid to a licensed acupuncturist. (section 2706 and 2707 of the ACA).
What does this mean for you? ANY and ALL plans in the State of California must now cover acupuncture. The ONLY possible exception are plans that were "grandfathered" in:
A grandfathered plan is any coverage provided by a group health plan or a health insurance issuer in which an individual was enrolled on or before March 23, 2010. Additionally, employer funded plans can choose the benefits they offer and exclude acupuncture. Employer plans based in other states (Blue Cross of Illinois, for example) are subject to the mandated benefits for THAT state, not California. If acupuncture isn't mandated, you may not have the coverage.
Many insurance companies now cover acupuncture for the treatment of common disorders. Since consumer demand for natural healthcare has increased in recent years, more and more insurance companies are providing benefits. We participate in many insurance plans and have an insurance billing consultant on staff to handle your billing needs. The following is a list of some of the insurance companies that cover acupuncture. To see if your insurance has coverage, please call the office and we will gladly check your individual benefits.
Please note that we have many practitioners at our office and not all of them participate with the same insurance companies. Feel free to inquire at the front desk to ask if the practitioner you are interested in seeing is a participating provider with your particular insurance company. In some instances, even if you do not have actual insurance coverage, your insurance company may participate in a discount program that we honor, which can reduce your out of pocket expense. We are happy to bill your insurance as a courtesy to you upon verification of eligibility and benefits but please remember that verification of coverage is not a guarantee of payment or benefits. We will do our best to review your coverage in advance and work with you and your insurance company to help you get your visits covered.
