Acupuncture and Health Insurance

by Mark Whalen

When fielding inquiries about Acupuncture from potential patients, I am always asked if health insurance covers acupuncture.  Unfortunately, this is not a simple yes or no answer.   Dealing with insurance companies can be confusing and time consuming.  Hopefully this will help clear up any confusion.

Without getting into too much detail here is where the insurance issue currently stands:

  • Some insurance companies will have plans that cover acupuncture, but not all plans within that insurance company will cover acupuncture.  For those that have coverage, there is usually a limit on the number of visits per calendar year.
  • Most insurance companies do not cover acupuncture but they will contract with acupuncturists to be ‘preferred providers’.  What this means is that in exchange for being placed on the insurance companies website, the acupuncturist agrees to give their clients a discount.
  • Many employers are now offering Health Savings Accounts (HSA’s)/Flex Spending Accounts.  With these types of accounts, you are able to pay for acupuncture services and get reimbursed by your employer.  For these types of accounts, you must verify your benefits with your employer.

The easiest way to find out your coverage status it to verify your coverage with your insurance company.

Verifying Coverage

As a free service to our customers/potential customers, we are happy to verify acupuncture coverage for you.  In order to do so, you can call our office and provide us with your health insurance card information or we will make a copy of your card when you come in.

As noted above, we cannot verify your HSA/Flex spending benefits for you.

 

Current Insurance at Five Points Acupuncture & Wellness

Currently, Five Points Acupuncture & Wellness is able to (and happy to) bill the following insurance companies:

Company

Patient

Five Points

Harvard Pilgrim Health Care Pays co-pay at time of visit and patient is responsible for paying difference between billed amount and amount reimbursed to Five Points Bills insurance company
Blue Cross Blue Shield Federal Pays co-pay at time of visit and patient is responsible for paying difference between billed amount and amount reimbursed to Five Points Bills insurance company
Blue Cross Blue Shield Massachusetts Laborers No co-pay; patient is responsible for paying difference between billed amount and amount reimbursed to Five Points Bills insurance company
HSA/Flex Spending Pays in full at time of visit * Provides paperwork for you to be reimbursed

 

(*you will receive the 20% off of standard rate discount;  please note we have no control over your reimbursement rates)

Lastly, if you do not have acupuncture insurance coverage or an HSA type account, we will offer the 20% discount off our standard rate, whether or not Five Points Acupuncture & Wellness is listed as a preferred provider.

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At Five Points Acupuncture & Wellness, we hope to make it as easy as possible for you to navigate the health insurance issue.  If you have any questions, please feel free to contact us at 781-944-3000.

If more companies begin to accept insurance, we will be on the lookout so we can contract with them as soon as possible.

If your insurance covers acupuncture and it was not mentioned above, please call our office and we will contact the insurance company.  (This process, known as credentialing, can take up to 120 days).

 

 

-Mark

 

Mark Whalen is a Licensed Acupuncturist and Board Certified Herbalist and the founder of Five Points Acupuncture & Wellness in Reading, MA.

Mark Whalen – who has written posts on Acupuncture Reading MA - Five Points Acupuncture & Wellness.


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Five Points Acupuncture & Wellness
20 Pondmeadow Dr #107, Reading, MA 01867
Phone: (781) 944-3000
 

 

Serving Reading, North Reading, Wakefield, Burlington and the surrounding Middlesex County, MA areas.

Zip Codes: 01730, 01810, 01867, 01880, 01821, 01803, 01864, 01876,
01887, 01915, 01923, 01940, 01949, 01960
.