Robin Green, L.Ac. MTCM

Understanding your Acupuncture Insurance Coverage

 

We know that figuring out how much your insurance will pay for your sessions at our clinic can be confusing and we’ll do our best to help you understand your coverage.

First, it’s important to know that acupuncture benefits are not a guarantee of coverage. Unfortunately, your acupuncture coverage may not adequately cover your services at our office due to high deductibles, payment only for pain conditions, or misleading reimbursement policies by your insurance company.

 

Our Insurance Policy Regarding Payment

  1. We require payment in full at the time of service until we receive an “Explanation of Benefits” that confirms your coverage and benefits.
  2. You will be expected to pay the full $218 on your first session and $105 for follow-up sessions.
  3. Once we receive the “Explanation of Benefits” letter from your insurance company, we can refund any over-payment and collect your co-pay going forward.

 

If you have Cigna, United HealthCare, or Aetna

We can bill Cigna, United Health Care, and Aetna health insurances if the following criteria are met:

  1. You have “out-of-network” acupuncture benefits
  2. Your deductible has been met

 

If you have Blue Cross or Blue Shield

If you have acupuncture benefits with Blue Cross or Blue Shield health insurance, we can provide a special invoice, called a ‘superbill’ that you can use to mail into your insurance company and get reimbursed directly.

 

Check Your Insurance Coverage Ahead of Time

If you have insurance, the out-of-pocket cost for your visit will vary depending on your insurance coverage. We recommend that you call your insurance provider to check:

  1. If you have out-of-network acupuncture coverage
  2. What percentage of the fees will be covered
  3. The maximum amount the insurance company will pay (ex. Blue Cross typically will pay a maximum of only $35 per visit)
  4. If your deductible has been met
  5. How many visits you have per calendar year

 

HSA and FSA Accounts

HSA and FSA accounts can be used to pay for your sessions. Make sure that you adequate funds in your HSA/FSA account to cover the service fees. Check with your HSA/FSA provider to see if you need to provide them with additional paperwork or invoices before they will reimburse you