Do You Take Insurance?
This is one of the most common questions I am asked, especially within a few months of any new year. People spend their money and work hard for the health benefits they receive through work, and so it’s only natural to want to use these benefits for all aspects of caring for themselves. While many insurance companies are starting to offer more coverage and reimbursement for optical, dental, chiropractic and acupuncture care, a gap still exists between what is offered and what is requested.
Health Savings Accounts (HSA) are a wonderful benefit many companies have, and I always encourage clients to take advantage of this option if it is available. I recognize that this is another deduction from a paycheck that may not feel realistic when signing up for this, but this is pre-tax money that you can utilize to meet co-pays and deductibles, as well as paying for nutritional supplements, massages, acupuncture, and other self-care services throughout the year.
As we get the question of HSAs out of the way, we come to the million dollar question of insurance coverage. There can be a lot of confusion on this front, and it can be difficult to be clear about the services that are covered (and to what extent) in your plan. Regardless of the language in your insurance plan, before engaging in acupuncture services with any provider, I strongly recommend you call your insurance company directly for answers to the questions below. Unfortunately, I have seen many people who think they have insurance coverage for acupuncture be stuck with a large bill due to some nuances in the language of their plans. To avoid this, don’t assume anything, and take the time to ask the following questions (even if these seem silly or redundant):
- Is acupuncture, performed by a licensed acupuncturist, covered by my insurance plan?
- Do I need to meet my medical deductible before coverage kicks in?
- For what conditions may I be treated / are their limitations to conditions treated according to my insurance coverage?
- Is there a limit to the number of acupuncture sessions that are covered throughout the year?
- Do you offer coverage for treatment with “X” provider at “X” location?
It is becoming more and more common for mental health and “alternative care” providers to receive payment from the client up front. The provider will then provide a “Super Bill” with all the pertinent billing codes for services to the client to submit to the insurance company for reimbursement as indicated in the individual’s insurance plan. There are myriad reasons for a provider to choose this route, and this is the way that I handle insurance billing in my office. Clients pay me directly and submit claims to their insurance company (often through a simple phone app or document scan) for reimbursement.
Insurance coverage is a very real concern for many people, and in my experience, health care providers who are working for themselves or small companies want nothing more than to provide the best services to their clients, regardless of coverage. If your specific provider doesn’t do direct insurance billing, it is always worth a conversation to see if they offer cash or package discounts for those seeking care for which they can not be reimbursed.
While calling an insurance company may not be at the top of anyone’s Top 10 Fun Things to Do list, it does save a lot of hassle – and potentially money! – in the long run. I hope this helps and sees you in a healthy, happy and fulfilling New Year.
