Due to its late introduction into the United States, acupuncture had not been integrated with our current healthcare system until recently. It’s benefits have shown merit especially during these hard times of the Opioid Crisis. Today, Medicare has realized that many working-class Americans require acupuncture for most commonly : chronic lower back pain. In fact, the very cause of the Opioid Crisis is the unresolved issue of many kinds of chronic pain among our fellow American people.

Relationship of Chronic Pain and Opioid Crisis

Patients have relied on addictive opioid-based medications for pain relief because of the lack of any alternative treatment methods for pain. This has directly caused the heroin addiction epidemic. Essentially, patients leave hospitals with unresolved pain and continue to depend on opioid-based medications.

Soon or later, the patient is either clearly addicted and standard legal dosages are ineffective. They are forced to acquire them illegally, because they don’t have any more prescriptions. They will often use heroin and continue down a downward spiral of addiction. The situation becomes worse including losing their job, destroying relationships, and possibly ending up homeless. Not only has the common problem of pain contributed to physical suffering, it has now contributed to emotional heartache and financial disaster.

Without any clear way to treat pain effectively WITHOUT side effects or addiction, the current healthcare system seemingly had no way out the Opioid Crisis—until they found out about acupuncture.

Acupuncture vs Chronic Back Pain and Opioid Addiction

Acupuncture has been a method of healing since ancient times (at least 3000 years ago) and still remains one of the most commonly used forms of alternative medicine for back pain, gastrointestinal disorders, insomnia, emotional disorders, and most recently fertility.

The basic understanding of acupuncture is that it utilizes conduits within the body that transport substances that nourish, heal, and protect the body. It does so by inserting a variety of needles, most notably the sterile hair-thin filiform needle, into the skin to stimulate these conduits, which in turn activates the nervous system to facilitate a healing response by the body.

Acupuncture has been used effectively in the United States for many types of disease and syndromes since the early 70’s before it was even legal. After years of lobbying, research, and administrating acupuncture, it has finally been recognized by medical regulating body’s as not only as an effective medical practice, but possibly even a medically necessary procedure for pain. This is why it is now approved for Medicare coverage for lower back pain.

Does medicare cover acupuncture?

Acupuncture has been approved for Medicare coverage as of January 21, 2020. The fact it is now being covered is not a surprise, as many other health insurances such as BlueCross BlueShield of Illinois have started to cover acupuncture since early 2017. Here are the basic benefits and limitations:

  • ONLY covers for chronic low back pain
  • 12 sessions in 90 days
  • Additional 8 sessions for those patients with improvement
  • No more than 20 sessions per a year

In general, Medicare coverage for acupuncture will be subject to the same or similar rules: You’ll need a diagnosis from your primary physician for chronic lower back pain. They will then initiate an authorization, and once it is approved, you can see your acupuncturist for treatments for lower back pain.

Why does it only cover lower back pain?

CMS ( Centers for Medicare & Medicaid Services ) still considered acupuncture as subject to further research and study to fully understand the mechanisms behind its efficacy. As many are aware of, including many of our patients, acupuncture can help with many disorders besides pain. These include :

  • gastrointestinal disorders such as constipation, diarrhea, IBS
  • insomnia, anxiety, depression
  • reproductive disorders such as infertility, prolapse, irregular menstruation
  • headaches, migraines, dizziness, paresthesia
  • paralysis, Bell’s palsy, hemiplegia (often post-stroke)
  • diabetes, high cholesterol, high blood pressure

Thus, there is definitely a future for acupuncture with expansion of coverage for many other types of diagnoses including the aforementioned. Even so, acupuncture’s insurance coverage still hasn’t even touched a large part of Chinese medicine : medicinal herbs. These are essentially the natural, alternative equivalent to modern pharmaceuticals, which are in fact covered by some insurances. We look forward to insurance coverage expansion for other acupuncture modalities, alternative medicine, and natural herbs, so that more of those in need such as construction workers, nurses, government workers, and everyone else can have more access to alternative medicine in the future.

What steps can you take now?

Our team at Acupuncture Healing Center in Chicago with Nam Bac Hang has served the working class including yourself with affordable herbs and acupuncture for over 30 years, and you can say we are undeniably GLAD that we will able to do even more so with CMS’s finalized approval Medicare coverage for acupuncture specifically for lower back pain.

Currently, we are NOT contracted with Medicare, as this has just been announced recently. It would take time for us to be in the system. Probably by mid 2020, acupuncture Medicare coverage should be fully implemented.

What you can do for the time being

  • Enroll in Medicare
  • See your doctor if you have had chronic back pain
  • Request that they initiate an authorization for acupuncture at one of our facilities
  • Wait for approval then set up an appointment