Slowly, but surely, the insurance industry is embracing acupuncture as a viable coverage option for its plan participants, giving more people the ability to take advantage of the valuable services you provide. However, current coverage generally stipulates calendar-year visit limitations depending on the plan.
But that's not the case with Tufts Health Plan, which ensures more than 1 million members in Massachusetts, Rhode Island, New Hampshire and Connecticut. Tufts has announced that effective Jan. 1, 2020, members of its fully insured commercial health plans, including employer-sponsored plans, can enjoy unlimited access to acupuncture. Members will be required to pay only the standard co-pay they pay for a primary care provider or specialist visit as stipulated by their plan type.
Even more encouraging, members can visit an acupuncturist without prior authorization or referral via Tufts' network of acupuncture providers.
"Acupuncture has a wide range of uses and can particularly be helpful in the area of pain management," said Claire Levesque, MD, chief medical officer for commercial products at Tufts Health Plan. "Expanding our acupuncture coverage is just another way we are working to help our members receive the holistic care they need and deserve. This new acupuncture benefit, in conjunction with our discount program ensures alternative health care remains accessible and affordable to our members."
Will Tufts' unlimited-visit design eventually be replicated by insurers in other states or nationwide? One thing is clear: Although the AOM profession has become accustomed to all-cash transactions because patients lack insurance coverage for acupuncture, times are changing. The end result: More people having access to your valuable care.
Whether you accept it, avoid it or live somewhere in between, insurance coverage has become a defining issue for our profession. Patients increasingly expect to use their benefits, practitioners want to be compensated fairly for their time and expertise, and the system itself remains – at best – fragmented. The encouraging news is that coverage has expanded in meaningful ways. The challenging news is that reimbursement, across the board, remains inadequate.
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