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Do Medicare Advantage Plans Cover Acupuncture?

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If you suffer from chronic pain, you may be desperate to find effective treatment. If you’re wary of the side effects of prescription painkillers, you might be interested in acupuncture.

According to the Mayo Clinic, acupuncture involves inserting very thin needles into strategic points on the body to treat pain. Acupuncture can also be used for overall wellness, including stress management. Acupuncture can treat chemotherapy-induced nausea, migraines, osteoarthritis, menstrual cramps, and respiratory disorders among other problems. Acupuncture has been used for thousands of years in China and for decades in parts of Europe although the efficacy is unknown in the United States according to the Centers for Medicare and Medicaid Services (CMS).

In 2012, a study by the Centers for Disease Control and Prevention (CDC) revealed that only 25% of survey participants had insurance coverage for acupuncture. Like much other insurance coverage, Original Medicare (Part A and Part B) generally doesn’t cover acupuncture. According to CMS, acupuncture is not considered “reasonable and necessary.” Pending scientific assessment has not yet established how effective acupuncture is so Medicare cannot reimburse patients for acupuncture. If you have Original Medicare, you’ll likely pay for acupuncture out of pocket.

How much does acupuncture cost?

Your acupuncture practitioner may review your full health history before beginning treatment. The cost of an acupuncture appointment may include the initial consultation and the actual acupuncture treatment. You may also receive follow-up consultations along with your continued treatment. Call your acupuncture office in advance to ask what a session costs. Acupuncture costs may vary from area to area. The total cost of your acupuncture treatment will also depend on how many sessions you need.

What is Medicare Advantage?

Medicare Advantage is a way to get you Medicare Part A and Part B benefits from a private insurance company. When you enroll in a Medicare Advantage plan, you’re still in the Medicare program and are required to pay your Part B premium along with any premium the plan charges. Medicare Advantage plans must cover everything that Original Medicare covers and often offers additional benefits. Some extra benefits covered by Medicare Advantage plans could include routine vision, routine dental, prescription drugs, and routine hearing. Please keep in mind that not all Medicare Advantage plans cover the same services, and benefits may vary by plan.

Does Medicare Advantage cover acupuncture?

Because Original Medicare generally doesn’t cover acupuncture, Medicare Advantage plans are not required to cover acupuncture either. However, some Medicare Advantage plans may cover acupuncture. To find out exactly what your Medicare Advantage plan covers, contact the plan provider. In some cases, your acupuncture provider may require payment at the time of treatment. You may then submit this bill to your Medicare Advantage plan. If you Medicare Advantage plan does cover acupuncture, it may require you to see providers that at are in-network.

To enroll in a Medicare Advantage plan click Browse Plans on this page to display plans in your area. Do you still have questions? For personalized assistance, call eHealth to speak with a licensed insurance agent.

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