Understanding the ins and outs of health insurance coverage, Health Savings Accounts (HSAs), and what is commonly covered in Pennsylvania and nationwide can be tricky to follow as the new laws unfold and things change quickly. Here we explain some of these topics and how they affect you and your acupuncture care.
In 2012 when Pennsylvania rewrote their Essential Health Benefits list to determine what would be covered by most insurance policies, the state decided to default to a popular small business plan that did not include acupuncture coverage across the board.
However, some local plans do cover acupuncture, but often only for very specific conditions such as chronic migraines and cancer treatment support to help with the side effects of chemo and radiation therapy.
A popular alternative is to use a HSA (Health Savings Account) to pay for your care. Many employers now provide their employees with a Visa or Mastercard HSA debit card to cover copays and non-covered services such as acupuncture and massage therapy. Some people invest their own money into a private HSA for flexibility in care. We gladly accept HSA cards at Life Balance Acupuncture!
Always check with your insurer to see if you are covered for acupuncture treatments and if there are any specifics or limitations to your care. If you are covered and your practitioner does not bill directly, he or she can provide you with a superbill for you to send into your insurance company for reimbursement. We provide superbills if you do have acupuncture coverage!
While being accepted by insurance has its benefits, there are also some downsides to being an in-network provider. For instance, with the new health care laws in place, plans that used to fairly reimburse acupuncturists are now finding ways to reject their claims or pay them as low as $8 per treatment. This is frustrating as many acupuncturists charge affordable rates and provide exceptional and personalized care that is rare to encounter in our face paced healthcare model. Not many providers can make a living off these absurd reimbursements some insurers are now paying for their services and time.
On the bright side, a new law included with the ACA is Section 2706: Non-Discrimination in Healthcare. This provision states that health insurers must reimburse providers that are licensed in the state and are providing care under their state's scope of practice. This allows patients to choose if they would like to see an MD, an acupuncturist, a chiropractor, or a massage therapist. Click here to read the ins and outs, pros and cons of this provision in plain language.
This is helpful because in many states still, MDs that have MINIMAL (weekend) training in acupuncture and are allowed to perform it are covered and reimbursed, yet licensed acupuncturists (who are licensed under the state medical board and have over 2500 hours of diagnostic skills, Eastern and Western Medical theory and training, and needle safety and needling skills practice) are not reimbursed. This is a grave oversight and a huge disservice to patients seeking qualified practitioners.
To be fair, this is not to say that all MDs practicing acupuncture have not had adequate training.
Some MDs go through an entire 3-4 year acupuncture program and become L.Acs. Others continue their training to learn more about diagnosing from an Eastern perspective. Most are practicing "Medical Acupuncture" and it is quite different from traditional acupuncture.
It is always best to ask for your acupuncturist's credentials, licensure, and training based on your treatment needs and goals.
Over the next few years, acupuncture coverage in health insurance plans may become common place. However, do not disregard getting treated now because you may have to pay out of pocket.
Acupuncture is very effective and has helped millions of people heal on a deep level. It is worth your time and investment. In the long run, the money you will save on 'sick visits' to the doctor will pay for itself. Acupuncture keeps you well and is a wonderful form of preventative medicine for most people.
We hope you have a better understanding of the current issues and solutions facing patients and practitioners alike in the complex world of health insurance!
Acupuncture isn't just for humans! Furry and not so furry creatures alike can enjoy the benefits of acupuncture. Veterinarians that incorporate acupuncture into their practices discover that their patients often require less medications and surgery. Animals respond well to acupuncture; just look at how relaxed little Paulo the howler monkey is pictured above.
Some people think you have to 'believe' in acupuncture for it to be effective or that is only works as a placebo. Other creatures do not have belief systems like we do, yet still receive great benefits after treatment. Perhaps our own close mindedness and perceptions of acupuncture being 'mystical' rather than an effective form of medicine hamper and sabotage our quest for health and healing.
With that said, it's good to question things, do research, and most importantly, see for yourself! If Fluffy and Fido feel fantastic after their acupuncture sessions, why wouldn't you? Click the button below to schedule an appointment for yourself!
Click on the picture above to see more great photos of animals getting acupuncture!
Click here to contact a local Pittsburgh Veterinarian who makes acupuncture house calls for your pets!
We all want to feel our best, look our best, and be our best, but it doesn't always come easy. As we age and experience the ups and downs of life, sometimes we find ourselves knocked off our course. The good news is, is that we can always make progress and get ourselves back on track. The bad news is that sometimes it requires a lot of time, desire, resources, and discipline.
If we can stick to a new habit or stop an old one for around 21 days, our amazing brains can ingrain the new healthier behavior pattern into our regular routine without a second thought.
But sometimes just getting to the 3 week mark can be quite difficult, especially if we don't truly see the value in investing in ourselves and our health.
It's quite common to see people take care of their cars and their pets better than they care for themselves. As much as we value independence, individuality, and the self in our culture, some people see those that participate in regular self care as being selfish. Perhaps you feel guilty when you pamper or spoil yourself or you feel you don't deserve to spend some money or time out for yourself. We often place more value on objects and goods than our physical and mental well-being.
This type of thinking is crazy, but common. If we don't take good care of ourselves, how can we be our best for anyone else that we love and care for in our lives? We simply cannot for long.
Acupuncture is a form of self care that heals the body on all levels-physical, mental, and emotional/spiritual. It may not 'fix' everything within a few sessions, but it is an amazing way to support yourself and keep yourself balanced and healthy throughout different phases of your life. It is a worthwhile investment that usually leads to more energy and motivation which will in turn lead to even more positive and long lasting lifestyle changes.
If something happens that throws us off course again, acupuncture can support us and quickly put us back on the right track.
Many of us look for reasons and make excuses as to why we can't commit or invest in our health--lack of funds, time, patience-- it's all baloney. When we really want something we always find the time and find a way to make it happen. Make yourself a priority and stick to your treatment plan. It will be worth it and your investment into acupuncture will pay for itself in the way you look, feel, and heal over time!
The new up and coming buzzword in health care is Functional Medicine. Great! So what is it? The Institute for Functional Medicine defines it as something that sounds quite familiar to acupuncturists and practitioners of Chinese Medicine! They state that:
Functional Medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership..
Functional medicine is the wave of the future, but it certainly isn't anything new. The approach to a treating the root cause of disease and treating the patient as a whole person may be a new concept in our traditional healthcare system, but this approach has always been the foundation of Chinese Medicine.
You already get this holistic level of care from acupuncturists, but the good news is, more doctors will begin to see their patients as a whole, unique individual and treat them that way as well. Different types of medical practitioners will collaborate and work together to bring about true health and wellness, and focus on prevention instead of symptom management.
Sarah is the owner of Life Balance Acupuncture in Pittsburgh, Pennsylvania.