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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)

 

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