Changes on Insurance Coverage for 2020

Yes, we DO accept insurance!

People ask every day, but of course the answer isn’t so simple.  Every insurance company has different plans, providers can be in or out of network, there are deductibles to be met, and limits applied.  Acupuncture, one facet of Traditional Asian Medicine, is relatively new in the United States, having only officially arrived in 1971, though Asian practitioners entered this country more than a century earlier.  Some specific insurance plans have covered acupuncture for over a decade, but with the recent outcries around the opiate crisis, a growing dissatisfaction with the current medical model, and the steadily amassing scientific proof of efficacy, our healthcare system as a whole is coming to embrace, if not yet the whole of Traditional Asian Medicine, at least acupuncture.  2020 is shaping up as a definitive year of change.

 

We have been an insurance provider for 4 different companies over the years, but have been accepting only Blue Cross/Blue Shield Rhode Island for the last decade or so.

Through them, we can also submit to any other Blue Cross, though they are separate companies, with their own restrictions.  Information on coverage for each of these companies must be obtained directly by the insured, as we do not have access. The FEP (federal Employee Program) is fairly liberal in their acupuncture coverage. 

 

We have received word that some BC/BS RI Medicare Plans, including at least BlueCHIP for Medicare Value (HMO-POS), BlueCHIP for Medicare Extra (HMO-POS), and HealthMate for Medicare (PPO) now cover acupuncture.  We will be able to submit these claims for you directly.

 

BC/BS Massachusetts has begun covering acupuncture this year.  Up to 12 visits per year, no referral required, normal specialist copay.  Check online or phone their office if you have a plan through them. 

 

For the past few years, acupuncture has been offered at various VA hospitals, Department of Defense Facilities, and in some battle zones.  It is clear that the military understand the value of this medicine.

 

We have been informed that TRICARE will likely be adding acupuncture coverage sometime early in 2020.  9.4 million uniformed servicemen, retirees, and their families may imminently be eligible for acupuncture and chiropractic care.  There will likely be limitations, such as those conditions listed below for Vets.

 

We are in the process of applying for providership to the US Veteran’s Non-VA Care Office via the Veteran Affairs (VA) Patient Centered Community Care (PC3) / Veteran’s Choice Program (VCP), and will definitely expand into TRICARE through this avenue.  So, US Vets, service people, and retirees should soon be able to utilize acupuncture as a resource for pain relief due to illness or injury, of the low back, of osteo-arthritic knees; nausea and vomiting after an operation or chemotherapy; mental health concerns including depression, and substance dependency.

Currently, a referral is required to take advantage of this service.  

 

One day they may expand this to also cover illness, fertility, and wellness treatments, paving the way for a happier, healthier service population.  I have had the pleasure of treating (and helping) a large number of our service people and their families, and I cannot imagine a more effective and economical health alternative for our hard working military.

 

Also starting This month, Tufts Health Plan’s (available in Massachusetts, Rhode Island, Connecticut, and New Hampshire) fully insured commercial plans, including employee-sponsored plans, now allow for unlimited acupuncture treatments with one of Tufts network of acupuncturists: unlimited access, no authorization or referral required, for their standard specialist copay.  Plans previously offered 20 visits per year. Reimbursement for Out of Network providers can be gained through Tufts Health Forward.

 

Times are changing for insurance coverage of acupuncture, and this seems to be the year for a big surge!  The Opiate Crisis and active military use of the medicine have no doubt contributed. 

Medicare has only recently begun to consider acupuncture coverage, but reformation is on its way.  SO, call your insurance company, ask if they have made any changes to your plan, or whether there may be a more progressive plan for you.  While you are at it, check:

 

If acupuncture is covered

How many visits are paid per year

What your copay is

What your deductible is, and when it has been met: in network, and out of network limits may well be different.

Whether your provider needs to be in network, or whether further restrictions apply

(We are a BC/BS in-network provider)

 

Then schedule your appointments for a healthy 2020!  

 

You might consider regular visits to take advantage of this healthy option, keeping on top of illness and injury.  Schedule once a month, or quarterly, to stay balanced.

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