The Stram Center for Integrative Medicine

By: Christopher Reilly, L.Ac

The single biggest hurdle for acupuncture in New York is a lack of insurance coverage. MVP Gold, Goldanywhere and Trivantage, as well as BlueShield of Northeastern New York’s Blue Health Plus and Aqua programs cover acupuncture. Most plans, however still lack good acupuncture coverage.

Some insurance companies have a directory of acupuncturists that have agreed to give their customers a discounted service. This is not real coverage. The acupuncturist takes a cut in his or her rates in exchange for the advertising in the insurance directory. The insurance company isn’t supplying any reimbursement.

Some NY insurance companies will provide coverage for acupuncture only when performed by a certified acupuncturist (C.A.), not when performed by a licensed acupuncturist (L.Ac.). The requirement for a C.A. is to have only 200 hours of training in acupuncture theory and practice (which may be over the internet)and only 100 hours of supervised clinical experience. A L.Ac. in contrast, is required to have earned a three-year Masters degree in acupuncture consisting of at least 1,450 hours of classroom and clinical (not internet) training, and must pass a national level examination to achieve national certification. Most Masters degree programs have well over 3,000 hours of training.

Seeing that L.Ac.’s have literally ten times the training of C.A’s, and have proven their knowledge of acupuncture by taking a national exam, why would anyone want to see a C.A. instead of an L.Ac.? A certified acupuncturist is a physician or dentist who has taken a certification course.

Insurance companies may feel that a M.D. or dentist will make a more effective and safe acupuncture therapist. A study published in The Archives of Family Medicine in 2000, however, found that medical acupuncturists reported more than twice the amount of adverse events compared to full-time acupuncturists. The difference? For a L.Ac. acupuncture is the focus of their entire day and practice, and is an extensive field in its own right.

On many occasions, I will have a client who has already tried acupuncture from a C.A. with no relief. Working with me, these same clients often see substantial relief. Not only is there financial harm to those paying for a C.A. when they could be receiving more effective care, but there is also harm to the profession of Acupuncture when patients think it can’t work for them merely because their therapist has not been adequately trained.

Seeing your physician for acupuncture is like seeing a urologist for a brain trauma. A urologist has training in the basic sciences of human health, but they are not the experts for brain trauma. Likewise with acupuncture- it is best to see the experts.

The answer? As consumers we should let our insurers know that we are aware that acupuncture is a proven therapy, and that we demand service from fully-trained professionals who are equipped to serve us best. Insisting on proper coverage is an integral part to being active participants in our own healthcare, and to helping change how medicine is practiced in our time.