If you’re dissatisfied with your current pain management routine, acupuncture may be an option you’re considering. Acupuncture is an alternative form of medicine and a staple of traditional Chinese medical treatments. It involves the application of needles to pressure points in your body with the goal of relieving stress and pain. Although the procedure sees wide use around the world, it is not based entirely on scientific knowledge. For that reason, acupuncture has yet to be accepted by portions of the medical community.
This lack of acceptance may partly explain why acupuncture is not currently covered by most Medicare plans, even though the procedure is commonly used in conjunction with other forms of treatment. Acupuncture treatments can also be expensive. US-based specialists typically charge an average of $120 per session for their services.
If you have Medicare Part A or Part B and you choose to receive acupuncture or acupressure treatment, you will pay 100% of the costs out of pocket. If you have Medicare Part C (sometimes called the Medicare Advantage plan), it may include services like acupuncture that don’t fall under Medicare Part A or Part B coverage areas. To determine whether your Medicare Part C plan covers these services, talk with your plan.
Generally speaking, Medicare will only cover treatment programs that are deemed medically necessary by a licensed physician or authorized medical provider. If you are trying to qualify for coverage, ask your doctor or acupuncture specialist to document why the treatment is necessary for you.
Could it be covered in the future?
Despite the fact that Medicare doesn’t currently cover acupuncture services, there is some good news if you’re looking for financial aid. In August of 2015, California representative Judy Chu sponsored a bill known as the Federal Acupuncture Coverage Act. This bill sought to grant licensed medical provider status to acupuncturists and make the acupuncture procedure reimbursable under Medicare. To date, the bill has not been successful. However, several versions of it have been introduced in Congressional sessions over time. Eventually the bill may receive enough support to become law.
If you can’t wait that long, you can check with your insurance company. Some private carriers cover acupuncture procedures, but there are usually restrictions on coverage. Some insurance company plans only cover acupuncture when it is used in place of anesthesia for pain management. Others will only cover the procedure if a licensed doctor performs it.
Another option to consider instead of Medicare coverage is an HSA, or Health Savings Account. This is a tax-exempt account set aside for medical expenses. After you contribute to the account with pre-tax income and use it to pay for medical expenses, the account reimburses you for approved procedures. Consult with your tax advisor or your employer benefits manager to determine if an HSA will work for your acupuncture needs.