Insurance Coverage
Most Health Insurance Plans Cover Acupuncture Care

Many insurance companies now offer policies that cover acupuncture and related services, such as acupressure therapy, far-infrared heat treatments, and etc. performed by a licensed acupuncturist. This ongoing trend is that acupuncture coverage is becoming more commonplace with California health insurance plan. In general, health plans have quickly moved towards more preventative health care and alternative health care costs. Acupuncture is usually grouped under the "alternative health care" banner with chiropractic. However, it has become the mainstream both in terms of use and as a matured and licensed means of medical care simply because of its safe and economic efficiency in treating many chronic conditions and preventive health care.

Since the underlying issues that require acupuncture care are typically more chronic in nature (last long periods of time if not indefinitely), there may be caps on the number of covered benefits in a given year. The actual covered acupuncture and acupressure benefits also depend on the health plans you selected.

PPOs cover acupuncture care

PPO Plan (Preferred Provider Organization) - gives you the freedom to visit any provider who's right for you. You don't need to choose a primary care physician (PCP) and you don't need a referral to see a specialist such as an acupuncturist like us.

HMO Plan (Health Maintenance Organization) - requires that you select a primary care physician (PCP) who is responsible for managing and coordinating all of your basic healthcare services. If you need care from a physician specialist like us, your PCP will have to provide you with a referral. If you do not have a referral or you choose to go to a doctor outside of your HMO's network, you will most likely have to pay all or most of the cost for that care. Many practioners do not participate in health carrier networks. Unfortunately, many practioners do not participate in health carrier networks. Therefore, your selection to visit specialists is very limited.

EPO Plan (Exclusive Provider Organization) - is a mix between an HMO and a PPO, except that it only allows you to see physicians that are in the EPO's network, unless it is an emergency. However, for acupuncture care, some EPO plans allow patients to see acupuncturist outside the network. If you have EPO plan, please call us to verify your acupuncture benefits.

POS Plan (Point of Service) - is similar to an HMO. You are required to designate an in-network physician to be your primary health care provider. You may go out-of-network if you choose, but in doing so, you will have to pay most of the cost yourself, unless a primary care physician refers you to that specific doctor.

General Guide - Benefits and Coverages
Plan Requires PCP Requires Referrals Pays for
out-of-network care
PPO No No Yes Yes
(most plans)
HMO Yes Yes No No
EPO No No No Maybe
(need to check)
POS Yes Yes Yes
(requires PCP referral)
(but requires PCP referral)