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Does Insurance Cover Medical Acupuncture in California?

Updated: Jun 8

Healthcare has seen a significant evolution in recent years, particularly alternative treatments such as medical acupuncture. Once considered peripheral in Western medicine, acupuncture is now increasingly recognized as a mainstream treatment option. Amidst this changing backdrop, a common question arises among Californians: Does insurance cover medical acupuncture? The pioneering efforts of professionals like Dr. Anas Hana, MD, who integrates Eastern and Western medical practices, have been instrumental in this transition.


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Meet Dr. Anas Hana: A Confluence of Eastern and Western Medicine

Introducing Dr. Anas Hana is essential to discussing insurance coverage for medical acupuncture in California. Dr. Hana, a primary care physician based in Berkeley, brings over 16 years of experience from San Francisco Kaiser Permanente, managing the care of more than 2,000 patients. A graduate of Damascus University School of Medicine, Dr. Hana underwent extensive training in internal medicine in Chicago and completed a general medicine fellowship in South Carolina.


Dr. Hana’s unique approach to medicine combines Eastern and Western methodologies. He holds board certifications in Internal Medicine and Medical Acupuncture and is a member of the American Academy of Medical Acupuncture. His expertise extends to Asian bodywork, acupressure, and medical acupuncture, with comprehensive training in the USA and China. Dr. Hana’s commitment to holistic care is showcased in his integrative practice at Hana Holistic Medical Center, serving the Berkeley and San Francisco communities.


Understanding Insurance Coverage for Medical Acupuncture


Insurance Coverage at Hana Holistic Medical Center in Berkeley, CA


Located in the heart of Berkeley, Hana Holistic Medical Center proudly accepts MediCal insurance through Alameda Alliance, covering acupuncture as part of the benefits provided under the Obamacare Act. Please note that we are not familiar with LA Care, which is specific to South California.


Additionally, Berkeley students can benefit from our services under the SHIP/WellFleet insurance. With this coverage, students are entitled to 12 acupuncture sessions at our center, requiring only the payment of their copay. For more information on SHIP benefits, visit UHS Berkeley’s SHIP Benefits page.


Key Factors in Acupuncture Coverage

When considering health plans that cover acupuncture, several factors are critical:


Number of Office Visits:

Many insurance plans limit the number of office visit copays per calendar year, including those for acupuncture. It’s important to determine if acupuncture visits are included in the standard office copay visits and to verify the number of visits allowed. For more information on acupuncture services and appointments.

 


Provider Networks:

A significant number of practitioners are not part of health carrier networks. This can lead to higher out-of-pocket costs (for PPO plans) or no coverage for services rendered by these providers. Checking the California doctor lookup to stay in-network ensures the best benefits. To learn more about the integrative medical services offered, including acupuncture, in the Bay Area.


Coverage Details:

Understanding the specific details of your plan’s acupuncture coverage is essential. This includes knowing the number of sessions covered annually and any prerequisites for coverage, such as referrals or specific medical conditions. For comprehensive details about these benefits, it’s advisable to consult the plan’s brochure or explore the “Benefit Details” section when obtaining an insurance quote. For further information on how to navigate these details and make informed decisions.


Treatment Caps and Chronic Conditions:

Given that acupuncture is often used to treat chronic conditions, be aware of any caps on the number of covered treatments per year. While these caps might be more lenient than those for other services, like chiropractic care, securing authorization for additional visits can be a challenge. It’s important to understand your plan’s limitations and how they might impact your treatment.


Small Group Benefits and Riders:

For those in the Small Group market, certain health plans offer acupuncture riders, which provide additional or improved benefits specifically for acupuncture. These riders can be an important consideration for employers and employees looking to maximize their health benefits. To explore more about these options and the benefits they offer.


Acupuncture in Modern Healthcare: A Growing Trend

The practice of acupuncture, originating in ancient China, has become a widely recognized medical procedure worldwide. Its prominence in the United States escalated in the 1970s, and by 1995, the number of nationally certified acupuncturists had grown significantly.


The FDA’s approval of acupuncture needles for licensed practitioners in 1997 further validated its use in medical treatments. Today, approximately one-third of acupuncturists in the U.S. are medical physicians, underscoring the integration of this traditional practice into modern healthcare.


Dr. Anas Hana: A Testament to Integrative Medicine

Dr. Hana’s extensive expertise in both Western and Eastern medicine is a shining example of the integrative healthcare movement. Coming from a traditional Western Medicine Background, he is foremost a physician.


However, his holistic approach, enriched by his specialization in acupressure and Tui Na, along with medical acupuncture, offers patients a comprehensive treatment approach. Those seeking an integrated treatment plan combining the best of Eastern and Western practices can consult with Dr. Hana and his team at Hana Holistic Medical Center. For more information or to schedule an appointment, please visit the Appointments Primary Care page


Overview of Acupuncture Insurance Coverage

Acupuncture, a traditional practice involving needle insertion at specific body points, is now more recognized in Western medicine and covered by many insurance plans, including Medicare and in California health plans.


Medicare Part B offers coverage for up to 12 acupuncture sessions over 90 days for chronic low back pain, with a possibility of 8 additional sessions if there’s improvement, capped at 20 treatments yearly. This coverage applies specifically to chronic low back pain, and only certain providers are eligible under Medicare. For detailed information, visit Medicare’s official website.


In California, the inclusion of acupuncture in health plans, especially after the Affordable Care Act, demonstrates a shift towards embracing alternative healthcare options. Visit CalHealth.net for an in-depth look at acupuncture coverage in California health plans.

 



 

Contact Hana Holistic Medical Center in Berkeley, CA

Need assistance with insurance for acupuncture? At Hana Holistic Medical Center, we help before your appointment. Contact us for dedicated support in Berkeley, CA.

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