If you’re in New York City dealing with a challenging health condition like chronic pain, you’ve likely considered acupuncture. It’s a powerful, time-tested medicine that uses ultra-thin needles to achieve pain-relief and restore balance. But the big question for many New Yorkers is: “Will my health insurance plan cover acupuncture?”
The short answer is: Yes, in the United States, most health plans offer some form of health insurance coverage for acupuncture treatments.
However, navigating your medical insurance can be confusing. The key to understanding your benefits lies in two terms: in-network and out-of-network. Understanding this difference is the single most important factor in finding the right health care provider and making the most of your benefits.
This guide will walk you through how to check your benefits and why choosing a specialist out-of-network provider on the Upper West Side might be the best investment you can make in your health.
Think of it like a contract. An in-network health care professional has a direct contract with your insurance company. An out-of-network provider does not.
Before you book, it’s wise to understand your specific coverage details. While you can call your plan provider’s customer service line, we know it can be a hassle.
Let us do the work for you! We are happy to verify your benefits on your behalf. Click here to access our secure online verification form.
If you’d like to call your insurer, here are the key questions:
This is a common question. According to the Centers for Medicare & Medicaid Services, Original Medicare (Medicare Part B) now covers acupuncture, but only for chronic low back pain. There are specific rules about the number of additional treatments allowed, however, because of a technicality, acupuncturists can not submit to Medicare directly. Until that is fixed at the federal level, there is no coverage for acupuncture if you only have Medicare.
Many patients have Medicare Advantage plans, which are offered by private companies and may provide broader coverage for acupuncture for other conditions beyond just lower back pain.
Typically, acupuncture is covered when your secondary insurance, if you have one, has acupuncture benefits.
Medicaid does not cover acupuncture in NYS.
You may have noticed a growing trend: the best specialists are moving away from the in-network model. The reason is simple: Quality of Care. As a specialist with a doctoral level degree and an unrestricted license to practice acupuncture and dry needling, my focus is on providing the highest standard of care.
In-network reimbursement rates can pressure clinics to shorten appointments. By being out-of-network, I can:
While both use thin needles, they are not the same. Dry needling is a technique focused only on muscular trigger points. Acupuncture is a complete health practice rooted in a comprehensive diagnostic system. It is performed by licensed acupuncturists who have undergone thousands of hours of training and are certified by bodies like the Accreditation Commission for Acupuncture and Oriental Medicine. The National Center for Complementary and Integrative Health is an excellent resource to learn more about the evidence supporting acupuncture.
Many insurance companies in New York recognize the effectiveness of acupuncture for a variety of conditions, including:
Navigating insurance is the first step, but the ultimate goal is feeling better. If you value personalized, expert care, an out-of-network specialist is often the best path forward.
We can help you figure it all out.
We offer a complimentary insurance benefits check for all new patients. Let us do the work for you.
Fill out our form online. We will personally verify your out-of-network acupuncture coverage and explain your benefits in plain English, so you can start your journey to better health with confidence.
