Does Kaiser Permanente Cover Acupuncture?

In the world of alternative medicine, acupuncture is a traditional practice that has been around for thousands of years. It offers benefits like pain relief, stress management, and overall well-being. Nowadays, more people are interested in it rather than conventional medicine.

With the growing popularity of acupuncture, people are curious about whether Kaiser Permanente health insurance covers this treatment in their plans.

So, does Kaiser Permanente cover acupuncture? The answer is yes but with some limitations.

In today’s article, we will discuss everything you need to know about Kaiser Permanente and acupuncture coverage.

Table of Contents

What is Acupuncture?

Acupuncture is a form of traditional Chinese medicine that involves the insertion of very thin needles into specific points of the body. This practice is all about rebalancing the energy flow (Qi) through pathways (meridians) in your body, which is key for your health.

According to modern medical research, acupuncture may stimulate nerves, muscles, and connective tissue. This stimulation boosts your body’s natural painkillers and increases blood flow.

It’s often used to treat pain, like back pain, headache, neck pain, and osteoarthritis/knee pain. Furthermore, it’s also used in addressing conditions like stress, anxiety, and various gastrointestinal disorders.

The World Health Organization says acupuncture is good for treating many things. It’s now used in regular healthcare for its healing effects.

How Does it Work?

Acupuncture works by stimulating certain points on the body, typically by inserting thin needles through the skin to trigger a healing response. This stimulation can impact the central nervous system, causing the release of chemicals into the muscles, spinal cord, and brain.

These biochemical changes in your body might help it heal better and make you feel good physically and emotionally. Science says acupuncture can boost your body’s natural pain relief, improve blood flow, reduce swelling, and impact the automatic nervous system.

Studies show that acupuncture points conduct electromagnetic signals, which stimulate the body’s biochemical responses, helping to manage pain and inflammation and to regulate blood flow and pressure, body temperature, and the immune system.

Benefits of Acupuncture

Acupuncture offers a plethora of benefits for both the mind and body, making it a comprehensive treatment option for various conditions:

Acupuncture helps to reduce pain like headaches, neck pain, and back pain. It can also help with stress and make you feel happier.
Acupuncture can make you feel relaxed, help you sleep better, and boost your immune system.
It can also help with allergies and stomach problems by improving digestion.

People feel more energetic and clear-headed after acupuncture.

How Much Does Acupuncture Cost With or Without Insurance at Kaiser?

The price of acupuncture can differ a lot based on where you are, the practitioner’s skill, location, your condition, and your provider.

According to GoodRX, the first visit costs around $112 without insurance, and follow-up visits can be about $80. However, prices can start at $15 to $400 at the beginning and $15 to $300 later on.

Kaiser Permanente members can get acupuncture at a good price. Some Kaiser plans pay for the whole session, while others may ask for a small payment from you, usually between $10 and $40 per session.

It’s important for members to consult their specific plan details or contact customer service to understand their coverage benefits and any out-of-pocket costs they may incur.

Does Kaiser Cover Acupuncture?

Yes, Kaiser Permanente does cover acupuncture under certain plans. This coverage is facilitated in partnership with American Specialty Health Plans of California, Inc. (ASH Plans), underlining Kaiser’s commitment to providing diverse and comprehensive health benefits to its members.

Members who want acupuncture can pick any acupuncturist in the ASH Plans network. This means there are many good professionals to choose from, helping members find the right person for their health.

It’s a significant step towards incorporating traditional and alternative medicine with regular healthcare, giving a full approach to patient health.

When You Need Acupuncture Care, Follow These Simple Steps:

According to Kaiser Permanente, if you need acupuncture treatment, here’s what you should do:

Find an acupuncturist near you who works with ASH Plans. Call 1-800-678-9133 (toll-free) or 711 (TTY for those with hearing/speech impairments) on weekdays from 5 a.m. to 6 p.m. PST. Or check out the ASH Plans website.
Book your appointment.

Pay for your visit to the office when you get there.

Also Read: Does Kaiser Insurance Cover Vasectomy?

Eligibility Criteria for Kaiser Coverage

To be eligible for acupuncture coverage under Kaiser Permanente, members need to be aware of the specific criteria and steps involved:

Plan Inclusion: Ensure that your Kaiser Permanente health plan includes coverage for acupuncture services.
ASH Plans Network: Use an acupuncturist who is part of the American Specialty Health Plans of California, Inc. (ASH Plans) network. Only services received from in-network providers are covered.
Referral Requirements: Some plans may require a referral from a primary care physician before acupuncture services can be accessed or covered.

Session Limits: There may be a limit on the number of acupuncture sessions covered per year, so check your plan details carefully.
Co-payment and Deductibles: You might have to pay some money (co-payments or deductibles) for each session, according to your health plan.
Medical Necessity: Your insurance may cover acupuncture only if it’s necessary for treating your condition.

How to Obtain Covered Services

If you’ve confirmed that your plan does cover acupuncture, there are some steps you must take to obtain covered services. This normally includes:

Give a Participating Chiropractor or Participating Acupuncturist a ring to set up your first check-up.
Check if you really need any extra services.

Your Acupuncturist will handle any approvals needed.
Our ASH Plan team will decide if the services are really needed.
We’ll share the criteria we use for authorization decisions.

Got questions or concerns? Reach out to the ASH Plans Member Services Department.

Alternatives to Kaiser Permanente for Acupuncture Coverage

Kaiser Permanente has acupuncture in their health plans. If you don’t have Kaiser or want more choices, there are other options out there.

Many other health insurance providers are recognizing the value of acupuncture as part of comprehensive health care and are starting to include it in their coverage plans.

Make sure to check your insurance or ask your provider about acupuncture coverage. You can also use HSAs or FSAs to help pay for acupuncture, which can save you money on this treatment.

In addition, community acupuncture clinics offer a cheaper option compared to regular acupuncture. These clinics give treatments in a group and cost less, so more people can try acupuncture.

Some providers may adjust fees based on what you earn. This helps make acupuncture accessible to everyone, no matter their money situation. Check with local providers to learn about their prices and any help they offer.

Conclusion

In conclusion, acupuncture presents a promising alternative for people looking for help with different health issues. It fits well into healthcare plans, even those from Kaiser Permanente. More insurance companies cover acupuncture now, making it easier to access a holistic approach to health. Patients can try acupuncture through insurance, community clinics, or using HSAs/FSAs, giving them different ways to benefit from this traditional method in modern medicine.

FAQ

Does Kaiser WA cover acupuncture?

Yes, Kaiser Permanente in Washington does cover acupuncture treatments, subject to specific plan details. Members need to check their policy or contact customer service to see if they qualify and know about any copays or deductibles. To be covered, they usually have to use an acupuncturist in Kaiser’s approved network for personalized healthcare.

Who should not get acupuncture?

Although acupuncture is usually safe, some people should be careful or skip it for certain health issues.

People with bleeding disorders or on blood thinners should check with their doctor before trying acupuncture. Also, if you have a pacemaker, be cautious as some acupuncture methods use electrical stimulation.

Pregnant women should talk to their healthcare provider since some acupuncture points could start labor. Before trying acupuncture, speak with a healthcare professional to understand the risks and benefits for your health.

Can acupuncture help with chronic pain?

Yes, many studies have shown that acupuncture can be an effective treatment for chronic pain, including conditions like back pain, neck pain, and osteoarthritis/knee pain.

It works by stimulating the body’s natural pain relief and enhancing its function. Patients should chat with their healthcare provider to see if acupuncture could work for their condition.

Is acupuncture covered for members outside of California?

Coverage for acupuncture services under Kaiser Permanente plans can differ based on the plan type and location. For members residing outside California, it is advisable to review the plan specifics or reach out to Kaiser Permanente customer service for detailed information on acupuncture coverage in their region.