Rates and Insurance

Most insurance plans cover acupuncture and massage, however your specific coverage depends on your specific plan that your employer chooses for you.

To find out how much your plan covers you can check your policy booklet, contact your company’s HR person, or phone your insurance company directly. Or bring in your insurance card to your first appointment, and we’ll check for you.

Typically you will receive a certain dollar amount (i.e. $300 – 500) toward a particular service. Amounts are decided on by each company, and may be negotiated by unions. Some plans also have a separate “health spending account” that are discretionary funds to use how you like!  It’s worth finding out about this!

To find out your specific plan coverage you can check your policy booklet, contact your company’s HR person, or phone your insurance company directly. Or bring in your insurance card to your first appointment, and we’ll check for you.

Many insurance companies now allow us to bill them directly on your behalf- it’s easy and the response is instant. There are situations where we aren’t able to direct bill, or where you will have to pay out of pocket:

·         If your plan doesn’t allow us to direct bill on your behalf, you will be required to pay for the services up front and submit to your insurance company for reimbursement

·         If your plan only covers a portion of the visit (i.e. 80%) you will have to pay the difference to the clinic

·         If you have reached your annual maximum coverage for the service

·         If your plan requires additional information, such as a doctor’s referral

·         If you have 2 plans, and the plan we are billing is a secondary plan

·         If it’s the first time using direct billing services for your plan, the insurance company sometimes blocks the first transaction to verify that it’s a legitimate claim. Once the insurance company has verified the claim, future claims can usually be submitted.

There is a 1-800 number on the back of your insurance card. To find out if your insurance plan includes acupuncture benefits, ask them:

• Does your insurance policy cover acupuncture?
• Do you need a doctor’s referral? If yes, does it need to be submitted to the insurance company first?
• What is the dollar limit for acupuncture per year?
• Is there a limit to the number of visits allowed per year? If so, how many?
• Is there an annual deductible on your plan? If yes, how much? Has it been met for this year?
• Does your plan have “health spending account”?

If you are interested in taking advantage of direct billing, please bring the following information to your next appointment:

• Your health insurance card
• If the plan is through your spouse or family member: the full name and date of birth of the planholder
• Details about your deductible and annual maximum coverage is helpful but not required!