Sunday, May 8, 2011

Does Flo's insurance cover acupuncture?

Figuring out whether acupuncture is covered by insurance can be tricky. Coverage varies by insurance provider and plan. For example, some Blue Cross Blue Shield plans cover 24 visits per year. Carefirst offers a 30% discount. Aetna covers it with limitations. Some plans require that only an MD trained in acupuncture will treat you.
You'll want to check your individual plan and call your insurance provider prior to scheduling a treatment.

Questions to ask your insurance provider:

  1. How many treatments do I get?
  2. How much will they cover/pay?
  3. What is the normal co-pay for acupuncture from a preferred provider? (This is the amount you would pay out-of-pocket for each visit to a practitioner on their provider list.)
  4. What percentage will I pay for out-of-network practitioners?  (This is the amount you would pay out-of-pocket for each visit to a practitioner who is NOT on their provider list.)
  5. Who must provide the acupuncture? (Licensed acupuncturist or MD?)
  6. Will I need a referral from an MD to see the acupuncturist?
  7. What is my deductible?
  8. What conditions are covered for acupuncture? (Many plans only cover the treatment of pain)
I know a woman who called her insurance company and told them her acupuncture treatments were cheaper and more effective than her diabetes medications so she asked them to cover her acupuncture treatments. They opted to cover them since she was going to be a long term client of theirs and she spelled out how she would be saving them money.

Acupuncture was included in the Health Care Reform Law, so as Health Care Reform gets rolled out over the next couple years, it will become more mainstream and more insurance plans will cover it.

As part of the reform, President Obama established an Advisory Group on Prevention, Health Promotion, and Integrative and Public Health. Recently appointed to this advisory group was Charlotte Kerr, RSM, BSN, MPH, MAc, who is an acupuncturist and faculty member at Tai Sophia Institute with an extensive background in the health care industry. This group's job is to
  • develop policy and program recommendations, and
  • advise the National Prevention Council on lifestyle-based chronic disease prevention and management, integrative health care practices, and health promotion.
This group is also working to make sure that the cost of health care gets reduced by incorporating more prevention mechanisms and low-cost health options. It's in the best interest of the government to see that acupuncture gets fully incorporated into our health care system since, when compared to MRI's, surgery & pharmaceuticals, it costs a fraction of the price and delivers equally effective results.

The real question, however, is how do our priorities line up with our health? We pay $100 a month for cable TV. We'll buy pounds of candy at Costco. Down pints of beer in a night. Drop $100 at Target on a weekend. Meanwhile, we're Vitamin D deficient from lack of exposure to the sun, our gym membership cards are dusty, sleep deprivation is killing us slowly, and obesity is eating us alive. But we expect to pay $10 for a copay that directly affects our own vitality? Boy these flesh suits we inhabit take so much maintenance! They are constantly reminding us that we are temporary.... don't let the moment pass you by.

No comments:

Post a Comment