Does Aetna Cover Acupuncture Treatments?

Medicare Part B covers 12 acupuncture treatments in a 90-day period if you have chronic lower back pain. If you show signs of improvement, Medicare will cover up to 8 additional acupuncture treatments for a total of 20 covered treatments in a 12-month period.

Aetna Medicare Advantage (Medicare Part C) plans are required by law to cover everything covered by Original Medicare (Parts A and B). This means Aetna Medicare Advantage plans do help cover acupuncture for qualified plan members.

Acupuncture is a traditional Chinese therapy that's utilized to treat pain, stress and other physical and emotional conditions. Traditional acupuncture is believed to work by balancing the energy channels (meridians) in the body. When the body's energy is balanced and flowing freely, this may promote healing and aid in relieving pain. Acupuncture is also commonly practiced as a Western medicine technique.

Does Aetna Cover Acupuncture?

Acupuncture treatments are generally covered through Aetna when the procedures are deemed medically necessary. Treatments must also be performed by healthcare providers who are practicing acupuncture within the scope of their medical licenses. Conditions that Aetna usually considers medically necessary pertaining to acupuncture treatment include: 

• Chronic back or neck pain (12-week minimum duration)
• Nausea from pregnancy 
• Pain caused by knee osteoarthritis
• Low back pain
• Temporomandibular (TMD) disorders

Experimental acupuncture treatments aren't usually covered by Aetna because they're not considered medically necessary. Some examples of conditions that fall under the experimental acupuncture category per Aetna guidelines include:

• Acne
• Allergies
• Bell's palsy
• Peptic ulcers
• Phantom leg pain
• Carpal tunnel syndrome
• Post-traumatic stress disorder
• Smoking cessation

Certain Aetna plans may limit coverage for recipients who opt for acupuncture instead of anesthesia for dental or surgical procedures, but other plans may provide additional coverage. Specific coverage can vary by plan, so it's important for Aetna recipients to verify their specific coverage benefits.

What Is the Process of an Acupuncture Treatment? 

During an acupuncture session, small needles are strategically placed on different points of the body believed to be directly correlated with the body's internal energy channels to help stimulate and balance the energy flow. Individuals generally receive treatment laying down on ergonomically designed tables.

Those receiving treatment are instructed not to move while the needles are inserted, and the needles stay in for up to 20 minutes.

In addition to acupuncture needles, some practitioners use heat, electromagnetic energy impulses, friction or suction/cupping techniques. It's important to note that acupuncture can affect everyone differently, and while some individuals may experience positive results after their first treatment session, others may require multiple sessions before healing takes place.

Is Western Acupuncture the Same As Chinese Acupuncture?

Traditional or Chinese acupuncture focuses on the body's energy flow and utilizes techniques to remove blockages to treat pain and other issues, but Western acupuncture follows the belief that acupuncture stimulates nerves and muscles, which can help increase the body's natural resistance to pain. Some practitioners use both Chinese and Western techniques and methods.

What Conditions Does Acupuncture Treat?

Research has shown that acupuncture may be helpful in treating conditions such as lower back pain, knee pain, tension headaches and anxiety disorders. Acupuncture may also aid in relieving symptoms of: 

• Nausea
• Pain after dental surgery
• Insomnia
• Arthritic conditions
• Menopause hot flashes
• Menstrual cramps
• Cancer treatment side effects

Is Acupuncture Painful?

Acupuncture treatments may cause slight pain when the needles are inserted into the skin and tissues. Acupuncture recipients may also feel slight pressure or aching in the affected areas.

Alternatively, some individuals may feel relaxed or energized following needle insertion without any pain. 

What Are Some Benefits of Acupuncture?

While the results of acupuncture can vary depending on the conditions being treated and how the individual responds to therapy, some may include reduced stress, pain relief, improved sleep and better digestion. An individual undergoing acupuncture treatments may also experience a sense of well-being and feel more centered and relaxed. 

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