Insurance

Will your insurance cover your acupuncture treatments?

If you have acupuncture coverage, it is possible that your medical condition is not covered. There are often restrictions on what conditions the insurance company will allow.

• Most plans only cover acupuncture for pain, and it may be limited to the location of pain.
• For example, Aetna is very limited to certain conditions: migraines and headaches, neck and low back pain, and osteoarthritis of the hip or knee. These plans won’t cover acupuncture for shoulder pain, fertility, or most other conditions.

Your plan may be limited in the number of acupuncture treatments it will pay for in a year.

Make sure you know if you have out-of-network (OON) and/or in-network (IN) coverage and what your deductibles are. If you have coverage, it will not start paying until your deductible is met.

How we work:

Our office is Out of Network (OON) for all insurance plans.

As a convenience for our patients with OON acupuncture coverage, we will submit the bills for you if you have:

• Horizon BCBS and most BCBS plans. (Note: OMNIA plans do not cover acupuncture)
• Aetna
• United Health Care
• Medicare Advantage Plans
• For all other plans, we provide superbills for you to submit yourself.
• Read about Medicare lower on this page

We will submit claims to your insurance provider if you have acupuncture coverage. You are responsible for payment at the time of service, and we will make adjustments/reimbursements or give you credit once we receive the first Explanation of Benefits (EOB).

If your insurance plan does not cover acupuncture, it qualifies as a flexible spending account expenditure. You can use your FSA or HSA card, or we can give you a bill to submit.

Medicare

Medicare is VERY restrictive in acupuncture coverage. It ONLY covers a limited number of chronic low back pain treatments and must be performed in a medical doctor's office to submit claims. Unfortunately, unless you have a Medicare Advantage Plan with acupuncture coverage. we cannot submit to Medicare at this time. This is not our choice; this is how Medicare works. They do not credential acupuncturists, so we can't submit unless we are working in a credentialed medical office.

Cost of Treatment and Acupuncture:

Since we are a medical clinic (not a spa), we cannot diagnose your medical condition or provide acupuncture cost estimates over the phone or email as we will not know the specifics of your case.

The cost of your acupuncture treatment is determined at your consultation. It is based on a medical case review of your condition and what will be deemed necessary for you to get better.

During your private consultation, Dr. Rhonda will answer any questions you have about your case, treatment plan, and pricing.