Study Finds Acupuncture Beneficial for 70% Of Those Plagued With Tension Headaches — But Does Your Insurance Cover It?

Study Finds Acupuncture Beneficial for 70% Of Those Plagued With Tension Headaches — But Does Your Insurance Cover It?

While the traditional Chinese practice provides benefits to those with chronic pain, insurance coverage is inconsistent.
Acupuncture for headaches

For many with chronic pain, acupuncture can be life-changing. Earlier this year, a study published in the journal Neurology found that the traditional Chinese medicine practice, which uses the placement of thin needles on the skin to stimulate specific points on the body, could relieve chronic tension-type headaches in nearly 70% of the cases studied. Most of those individuals had been suffering from the condition for over a decade and reported experiencing these painful headaches a whopping average of 21 days out of the month. After eight weeks of treatment, they now only experience headaches about seven days a month.

And benefits don’t stop at headaches. Numerous other studies indicate the practice can help treat chronic pain of the lower back, neck, knee, as well as other health concerns like nausea brought on by cancer treatments. One recent study even found acupuncture could work better than medication to treat and prevent migraines.

Unfortunately, clinical practice guidelines are inconsistent in their recommendation for the therapy, and as a result, insurance coverage for acupuncture varies from plan to plan as well. One thing, however, is consistent: You will most likely have to pay at least some of the cost of your sessions out of pocket. A recent survey of more than 1,000 people published in JAMA Network Open found that half of respondents said their insurance didn’t cover acupuncture, and of those who did get coverage, close to 60% still incurred out-of-pocket costs.

Here’s what you need to know before booking an appointment:

How much does acupuncture typically cost?

According to the recent JAMA survey, individuals spent, on average, $1,021 a year for approximately eight sessions. Those with insurance paid about half that cost ($554) out of pocket.

A 2019 study that looked at the cost of acupuncture in 41 U.S. cities found that the cost range for a first-time acupuncture visit was $15 to $400, with the highest median being $150 (in Charleston, S.C.), while the lowest was $45 (in St. Louis). For follow-up visits, the cost range was $15 to $300.

When is acupuncture covered by insurance?

As noted, coverage varies from provider to provider and plan to plan. Here’s a sampling of what some big insurance companies might cover:

  • Aetna: As of 2022, Aetna considers acupuncture as a standard benefit for the treatment of chronic neck pain and headache, lower back pain, pregnancy-related or chemotherapy-induced nausea, knee or hip pain from osteoarthritis, post-operative dental pain or temporomandibular disorders. If no benefit is seen in four weeks, the treatment plan may be reevaluated.
  • Cigna: Coverage is dependent on the type of plan you have. If your plan does cover acupuncture, it must be deemed medically necessary and is limited to conditions such as migraine, musculoskeletal joint and soft tissue pain, and pregnancy-related, chemotherapy-related or post-surgical nausea.
  • Kaiser Permanente: Acupuncture services are covered when a participating acupuncturist finds that the services are medically necessary to treat or diagnose neuromusculoskeletal disorders, nausea or pain. Not all plans provide coverage, but when they do, the copay is $15 per visit for a total of 20 combined visits per year.
  • UnitedHealthcare: Employer-sponsored plans may cover acupuncture (with a 30% copay for high-deductible plans) for up to 12 visits per year for pain relief or nausea that is related to surgery, pregnancy or chemotherapy.

Does Medicare cover acupuncture?

Yes, but it’s limited. Acupuncture is covered by two types of Medicare insurance plans — Original Medicare and Medicare Advantage — along with Medicare Supplement (Medigap) policies, but only for chronic lower back pain, which the agency defines as having no known cause (not pain associated with surgery, pregnancy or cancer) and lasting 12 weeks or longer. Medicare limits the number of treatments to up to 12 acupuncture sessions in 90 days, and allows eight more only if your condition shows signs of improvement, for a maximum of 20 acupuncture treatments per calendar year.

Can I use my HSA or FSA account to pay for acupuncture?

Yes! When recommended by a healthcare professional for a medical condition, the cost of acupuncture is a qualified medical expense that can be paid with funds from either an FSA or HSA account.