INSURANCE
Click on your insurance company
below for further information.
No Fault (car accident)
Medicare
Medicare supplement plans
Empire Blue Cross Blue Shield
United Health Care
Empire Plan
Cigna
Aetna
Oxford
HIP
GHI
Magna Care
Vytra
Please note...
No Fault
No-fault insurance pays for acupuncture treatment after an
automobile collision. While your case is active and open, no fault will pay 100%
for your treatments.
In recent years, there has been an increase in the number of clinics set
up specifically to do no-fault work. Unfortunately most of these clinics abuse
the system. Highly unethical billing practices are common. Patients, perhaps at the
urging of their attorney (who often makes the referral to a specific clinic) are
treated almost daily, usually with little informed consent to the treatment they
receive. The worst such “mills” hire people to stage accidents, then bill for
treatments that never occurred. With acupuncture treatment, practitioners
in such clinics are required to give treatments lasting perhaps a few minutes,
sometimes using only ear seeds and billing it as an acupuncture treatment (which
is insurance fraud). In short, most of these clinics are set up for revenue
generation purposes, not for patient care. It is a systemic problem involving
all covered modalities, and caused by those who put money ahead of patient care
and ethical billing practices.
At Classic Touch Acupuncture, the patient comes first. Each
treatment is individually tailored to your disorder and symptoms. Your
treatment typically lasts 45-60 minutes and consists of many different
modalities in conjunction with acupuncture (which we often do without
re-imbursement). We are more than happy to
speak directly with your insurance company, case worker, lawyer, or any
healthcare practitioners you are seeing. We provide extensive medical
notes for the insurance company as well.
Workman's Compensation
Workman's compensation will often
pay for acupuncture treatments. However, you must get written pre-approval
(claim#)-
They will then usually pay for 10-12 treatments with no out-of-pocket costs for
you. If you do not have written approval, call our office and we can try
to get approval for you.
Medicare & Medicaid
Medicare and Medicaid does not cover acupuncture treatments.
Medicare Supplement Plans
All Medicare supplement
plans follow Medicare guidelines. Therefore, these
plans will not
cover acupuncture treatments.
Empire Blue Cross and Blue Shield
We are a participating provider for Blue Cross/Blue Shield. Empire's regular plans usually cover acupuncture. (see below for HIP info). We do not require a referral for acupuncture and we do not need any kind of
note regarding your condition. (exception - HealthyNY plan does
require a referral from your doctor - please call us to find out what you
need.)
Acupuncture usually would then be covered for up to 12 sessions within a 12-month
period (calendar year). There is usually some sort of co-pay or co-insurance which
usually run from $12 to $25 per visit.
Example:
Empire POS - co-pay = $25 (each visit)
Empire PPO - co-insurance = (1st visit) - $30; (follow-up visits) - $10
Patients that have health
insurance plans with BCBS Federal, BCBS Verizon Plan, and BCBS Suffolk Co.
plan have coverage for acupuncture treatments for pain management with a per
visit co-pay.
These plans
may be limited to 6 – 12 acupuncture treatments per calendar year.
United Health
Care
United Health Care does not provide in-network coverage for acupuncture
performed by a licensed acupuncturist in the state of
New York. We will offer you a discount on our services and if you
have an out-of-network plan with a deductible (that covers acupuncture), we will submit invoices for
each treatment to your insurance company -- and when you reach your deductible
(if you have not already) your plan should cover most if not all of the cost
of treatment. Usually after that point there is no limit to the number
of treatments.
Empire Plan
–
NYSHIP – (Member ID starting with the numbers 890)
This Empire plan does not
provide coverage for acupuncture and no longer offers their discount program.
However, we will continue to offer a 20% discount to NYSHIP members.
Cigna
Cigna has plans that cover acupuncture and plans that do not. You can call
your insurance company to find out if your
plan has this benefit. If it does not, some insurance companies will
let you add the benefit for a low cost.
Depending on your plan, Cigna may cover acupuncture at 100% with a $10 - $30
co-pay or may cover at 80 -90% with the rest being patient responsibility. If
your plan requires paying co-insurance, the out of pocket cost to you is very
low ($5 - $10 per visit).
Aetna
Aetna has plans that cover acupuncture and plans that do not.
You can call your insurance company to find out if your plan has this benefit.
If it does not, some insurance companies will let you add the benefit for a low
cost.
Depending on your plan, Aetna may cover acupuncture at 100% with
a $5 - $30 co-pay or may cover at 50% -90% with the rest being patient
responsibility. If your plan requires paying co-insurance, the out of pocket
cost to you is very low ($5 - $15 per visit).
Oxford
Oxford often offers a discounted rate for their members.
HIP
HIP often offers a discounted rate for their members.
GHI
GHI does not cover acupuncture treatments. However, we will offer the same
discounted plan as HIP members.
Magna Care
Magna Care has plans that cover acupuncture and plans that do
not. Often they will only cover acupuncture if it performed by an MD. You can call your insurance company to find out
what your benefit plans are. If it does not, some insurance companies will let you add the benefit
for a low cost.
If you do have benefits, you
may have a co-pay ranging between $10- $35 per visit.
Vytra
Vytra has plans that cover acupuncture and plans that do not.
You can call your insurance company to find out if your
plan has this benefit. If it does not, some
insurance companies will let you add the benefit for a low cost.
Depending on your plan, Vytra may cover acupuncture at 100% with a $5 - $30
co-pay per visit or may cover at 50% -90% with the rest being patient
responsibility. If your plan requires paying co-insurance, the out of pocket
cost to you is very low ($5 - $15 per visit).
Please note:
We are
not responsible for any changes to your health insurance plans. Please make
sure to check with your insurance company, prior to your initial consultation,
for benefits.
(we
will also verify your coverage prior to your initial visit)
