Insurance Coverage for Acupuncture
Our office loves to help people use their insurance coverage! We are familiar with most local plans’ acupuncture coverage, and we’ve outlined this below. We are in network with Aspire and Landmark, and soon to be in network with Blue Shield. We can bill other plans as an out-of-network provider if you have verified your coverage in advance. We can give superbills when needed and you’re welcome to use flex or HSA accounts. We always keep your credit card securely on file, for insurance copays and in the event they don’t pay at all.
Aspire secondary to Medicare
These plans cover 4, 6, or 12 annual visits, with a co-pay from $0 to $20, depending on your tier. In addition, you can also take advantage of an additional 12 visits for chronic low back pain, and these visits must take place within 90 days.
Aspire (Coastal) Chomp employees
Chomp employees with Aspire have a $25 copay and an additional $35 fee for codes billed that Chomp’s Aspire does not cover (They only cover 15 minutes of acupuncture and we provide 45-60 minute treatments.) Your total out-of-pocket payment is $60 per visit.
Aspire (Coastal) Salinas Valley Memorial employees
A referral is required and you must have it in hand before your first visit – no exceptions. Then, acupuncture is fully covered for 24 visits. If treatment is needed beyond 24 visits an authorization will need to be obtained thru Aspire.
MPC employees with Anthem PPO plan
Acupuncture is fully covered, with six visits per diagnosis code and unlimited visits per year.
MIIS employees with Anthem PPO plan
Acupuncture is fully covered, with unlimited visits. This plan will also reimburse for office visits for functional medicine.
CALPERS Anthem PPO plan
Typically acupuncture is covered about 90% after a $500 deductible is met. The remaining amount tends to be about $11 per visit, and we keep a card on file to charge the small amount due after we receive the statement from insurance.
MCSIG Blue Shield plan
12/2/22: We have applied to be a provider so this will soon change: Local teachers under MCSIG get $2000 per year to spend on acupuncture and functional medicine (roughly 20 visits). However, your Blue Shield plan reimburses you directly, they don’t reimburse us. This means that you pay at the time of service, we send in the billing electronically at the end of the week, and within a month you should receive a reimbursement check.
FEP and other Blue Shield plans
12/2/22: We have applied to be a provider so this will soon change: Blue Shield covers well for the Federal employee plan (FEP). Any other Blue Shield plans must be a PPO for us to submit bills. All Blue Shield plans reimburse you directly, they don’t reimburse us. This means that you pay at the time of service, we send in the billing electronically at the end of the week, and within a month you should receive a reimbursement check (if you have coverage).
We are Landmark providers and your co-pay is $10.