We are in-network with most of the insurances. For specific coverage questions, please contact us or reach out to your insurance directly or refer to our Q&A section at the bottom of this page.
Please note: being in-network does not guarantee payment, and you are fully responsible for verifying your benefits and payments
Insurances We Are In-Network With:
- Auto Accident Insurance and Personal Injury Protection (PIP)
- Aetna
- Aetna Medicare PPO
- Ambetter
- BlueCross BlueShield
- Community Health Plan of Washington Apple Health (Medicaid)
- Cascade Care Plans of Washington (Marketplace plans through Washington Healthplanfinder)
- Coordinated Care
- First Choice Health
- Foreign Service Benefit Plan
- GEHA
- Great West
- Humana / Humana Medicare Advantage
- Kaiser Permanente HMO/PPO / Kaiser Permanente Medicare Advantage
- LifeWise
- Medicaid Community Health Plan of Washington (CHPW)
- Medicare Advantage Plans
- Molina Healthcare of Washington
- TriWest (Military insurance)
- Optum
- PacifiCare
- Premera Blue Cross
- Regence BlueShield
- UnitedHealthcare / UnitedHealthcare Medicare Advantage
- UMR
Medicare & Insurance Policy
We Accept Medicare Advantage Plans (Part C)
We are pleased to accept Medicare Advantage plans from major carriers. These plans often act as a replacement for Original Medicare and may provide generous coverage for acupuncture (including neck pain, back pain, headaches, and other pain related issues).
Common Medicare Advantage plans we accept include:
- UnitedHealthcare (including U Card & Dual Complete)
- Humana (Gold Plus / Choice)
- Regence / BlueShield (Medicare Advantage)
- Kaiser Permanente (Advantage)*
- Aetna (Medicare Eagle / Value)
Important Note on Original Medicare:
Please note that we do not bill Original Medicare (the red, white, and blue card) or Medicare Supplement (Medigap) plans.
- Original Medicare coverage for acupuncture is strictly limited to Chronic Low Back Pain under specific supervision requirements.
- Medicare Supplement (Medigap) plans follow Original Medicare rules and do not offer standalone acupuncture benefits.
If you have Original Medicare + Medigap, we welcome you as a Self-Pay patient. We can provide a Superbill for your records upon request.
Note: Most treatments for degenerative eye diseases are not currently covered by insurance.
Frequently Asked Questions (Q&A)
1.Q: Can your office check my insurance benefits for me?
A: Yes! Please email a photo of the front and back of your insurance card and your Date of Birth to lee@ableacu.com. Note: Online portals often provide limited details. We strongly recommend calling your provider directly to confirm your specific coverage and avoid unexpected bills.
2.Q: Do I need a referral to receive acupuncture?
A: Usually, no. Most commercial plans allow you to see us directly. However, HMO plans and military/VA insurance (TriWest) do require a prior authorization or referral from your primary doctor.
3.Q: I was in a car accident. Can I use my auto insurance?
A: Yes. We accept Personal Injury Protection (PIP) claims. Please bring your claim number, accident date, and adjuster’s contact info to your first visit.
4.Q: What should I ask my insurance company?
A: Call the number on your card and ask:
- Does my plan cover acupuncture by a Licensed Acupuncturist?
- Does acupuncture apply toward my deductible? If so, how much is remaining?
- Is there a limit on visits per year?
- Are specific diagnoses required for coverage?
5. Q: Are cupping, herbal medicine, manual therapy, and supplements covered by insurance?
A: No. Most plans only cover the acupuncture only.
- Cupping & Manual Therapy: If recommended, there is a flat $20 out-of-pocket fee per session.
- Herbs & Supplements: These are separate out-of-pocket expenses and cannot be billed to insurance.
6.Q: Why is my copay sometimes higher for my first visit or during my treatment plan?
A: Insurance requires a separate “Office Visit” code (CPT 99203/99213) whenever we perform a medical evaluation or re-evaluation. This typically adds $20–$30 to your standard copay if your insurance does not pay for that portion of the visit. This occurs:
- On your very first visit (Initial Consultation).
- During re-evaluations (typically every 30 days or every 6th visit).
- Any time we need to discuss new symptoms or significant changes in your health.
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