How to Use Insurance for Acupuncture
Effective in May 2019, I will start accepting insurance, so I can make my service more accessible to more people.
In California, acupuncture is considered to be a part of primary care, so it is covered by almost but the cheapest health insurance policies.
A quick intro to acupuncture and insuranceNot all insurance policies are created equal. There actually quite a bit of variations amongst them. But by and large, there are two types of policies: HMO and PPO
PPOThis is usually offered by BlueShield. And it is generally considered to be a higher end policy and it’s particular good for people who need access to specialists and people who want absolute freedom in choosing their own medical providers.The PPO policies are very straight forward when it comes to acupuncture. Essentially the patients are responsible for everything (by everything, I meant everything, not just acupuncture), until the deductible is met. Once the deductible is met, the benefits kick in. The benefits usually pays for 10 acupuncture session at almost full cost and a slightly reduced reimbursement amount for additional sessions. PPO policies usually prefer in-network providers and usually offer slightly more reimbursement for in-network providers, but I haven’t yet encountered a PPO policy that restricts the choice of acupuncturists to in-network. So yes, out-of-network practitioners are eligible for reimbursement too, albeit often at a slightly lower percentage.For PPO policies holders, the situation is very simple. You pay everything until you meet your deductible
HMOThis is a broad category, so essentially every non-PPO policy falls within this category. And most popular underwriters include Kaiser, Cigna, United, Anthem, etc.As a rule of thumb, HMO policies pay for 15-min of acupuncture treatment, and nothing more beyond (with very few exceptions). The patients do have the option to pay for additional treatment time beyond the usual 15-min limitation. So overall it is still a big boost to help save the costs for the patients.Acupuncture benefits under HMO usually do not require meeting the deductible first.
How to book an appointment with your insuranceThe procedure of booking an appointment on MeridianAHC.com is still the same, with the following difference:You need to specify that you plan to pay for the session with your insurance
- Provide the 4 things when booking your appointment
- You insurance provider and policy type
- Your insurance policy number
- Group number
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