Can acupuncture fees be claimed with health insurance? Find the cover you need
Acupuncture is a safe, traditional Chinese health treatment in which needles are inserted into your body’s pressure points to bring pain relief and to treat medical conditions. In Australia it's recognised as a viable treatment and can be included in extras cover for out of hospital services.
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Contents of this guide
How does acupuncture work?
Acupuncture stimulates the nerves, causing the brain to release hormones and other helpful chemicals that help you heal faster and feel better.
An acupuncturist will ask you what's wrong and then insert thin needles into the skin at strategic points around the body. They'll place each needle wherever they think it will have the most impact on your condition, drawing from both Chinese medical tradition and Western medical understanding of the nervous system.
It's a calming experience, because you'll most likely be lying down for the entire session while the practitioner monitors your progress and gently repositions the needles when necessary.
How is acupuncture covered by health insurance?
Acupuncture cover is considered an "extra", so you'll either have to have a standalone extras policy or a policy that combines hospital and extras. If your extras policy includes acupuncture cover, it will usually be under the "natural therapies" section alongside therapies like remedial massage and physio.
Beyond that, here are a few factors you should consider:
- Is your practitioner certified? To be covered, your practitioner must have a degree that complies with the Australian Guidelines for Traditional Chinese Medicine Education. This can be a Bachelor of Health Science (Acupuncture) or an overseas equivalent.
- Do you have a waiting period? If this is your first extras policy, you'll probably have a waiting period of around 2 months for natural therapies. If you're moving over from another extras policy with similar cover, the insurer may waive your waiting period but is not required to.
- Did the acupuncturist prescribe anything else? Your practitioner might prescribe traditional Chinese herbs to go along with your acupuncture, but your policy probably won't cover it.
- Do you have combined extras? Some policies have a separate benefit limit for each "extra", for example you might have $1000 worth of cover for extras, but it's capped at $100 toward dental, $100 toward acupuncture and so on. A combined policy will let you spend that entire $1000 on any listed extra you want. So go nuts and drop it all on acupuncture - just avoid getting a cavity in the meantime.
Who offers acupuncture cover?
The following table lists the health funds that offer acupuncture cover and what the benefit limits are.
*The policies listed in this table are extras only. However, in most cases these can be combined with hospital cover. Information last verified June 2017. Always read the PDS before buying a policy.
|Health fund||Extras policies and annual benefit limits*||Waiting periods|
|Cessnock District Health Fund|
|Frank Health Insurance|
|Health Care Insurance|
|Latrobe Health Services|
|Mildura Health Fund|
|Phoenix Health Fund|
|Queensland Country Health Fund|
|St. Lukes Health|
|Doctors Health Fund|
|Reserve Bank Health Society|
|Teachers Health Fund|
*The policies listed in this table are extras only. However, in most cases these can be combined with hospital cover.
What medical conditions can acupuncture treat?
The acupuncture tradition goes back more than 2,000 years, which is enough time for masters of the craft to develop treatments for almost any illness you can think of. However, it is important to remember that it should complement your existing medical treatment rather than replace it.
Here are just a few of the conditions acupuncture can help treat:
- Back pain
- Digestive problems
- High blood pressure
- Carpal tunnel
- Temporomandibular disorder (TMJ)
Acupuncture for weight loss
Acupuncture isn't just for pain and broken bones. It is becoming a more and more popular treatment for other "imbalances" like weight loss. Studies suggest acupuncture may help with weight loss when combined with more common methods like a healthy diet and exercise.
According to Chinese tradition, negative emotions like anxiety and over-worry can lead to imbalances in the digestive organs.
An acupuncturist will treat this with the "five point" technique by placing needles in five points in and around your ear. You heard that right! Your ear contains meridian points that affect all regions of your body, including these five related to weight gain:
- one point affecting the hunger response
- one point affecting the stomach (the main digestive organ)
- one point affecting the spleen (connected to the stomach)
- one point affecting digestive hormones
- one master point affecting pain and addiction
Acupuncture for fertility
If you're slamming back your vitamins, cutting out the toxins and tracking your ovulation cycles, you'd be glad to know acupuncture can fit right into your fertility routine.
If you're preparing for in vitro fertilisation (IVF), acupuncture can help to reduce stress, regulate hormones and encourage ovulation.
And since it takes two to tango, acupuncture can help men increase their stamina and energy levels, while also helping to improving sperm count and quality.
Acupuncture for pregnancy
Getting stuck with a bunch of needles might not seem like the best way to spend your pregnancy, until you find out that it may help with a lot of the other pregnancy-related nuisances like fatigue, morning sickness, aches, pains and swelling. Best of all, you can get that qi flowing to both you and your baby throughout the entire pregnancy (and beyond).
- First trimester. The acupuncturist might work on treatments to help prevent miscarriage, reduce morning sickness and channel nourishment toward the bub.
- Second trimester. This is generally considered the "easiest" trimester, so you may just go in for maintenance treatment.
- Third trimester. Acupuncture will be used to help your body adjust to all its rapid changes and to help you prepare for delivery.
- Post-birth. You can even get treatment after birth to help your body recover from the extraordinary experience that just occurred.
Acupuncture for anxiety
Anyone ever say you need to add some more yin to your yang? Well maybe they didn't put it quite like that. In Chinese medicine, anxiety takes on many forms but they're all caused by a deficiency in one of the yin-promoting organs. Acupuncture will specifically target each one, like so:
- Got anger or frustration issues? Acupuncture will aim to balance the liver and gallbladder energy.
- Worry a lot? Your spleen and stomach will be the target.
- Always feeling afraid? Let acupuncture restore balance to the kidneys and bladder.
- In a funk? Use acupuncture to send some qi to your lungs and large intestine.
Have a chat with your acupuncturist about your anxiety and they may also recommend some traditional Chinese herbs that can bring some of that healing yin back to all the right spots.
How do I claim acupuncture on my health insurance?
Your policy will most likely pay a percentage of the total bill for each claimable visit and you'll be responsible for the rest. Here are a few ways to get that refund:
- Swipe your membership card at checkout. If the practitioner provides this service, you can swipe your card and have the insurer's portion deducted from the total bill. You'll just pay the remainder.
- Claim online. You pay the total bill and then hit up your insurer for their portion later. When you get home, just login to your insurer's mobile app or website and follow the prompts to lodge your claim. They'll deposit their share into a bank account that you'd set up with them previously.
Does Medicare cover acupuncture?
Medicare doesn’t cover acupuncture treatment unless your doctor performs the procedure during a private consultation. In this case, you may be eligible for a Medicare rebate of $21. Acupuncture is also a WorkCover approved treatment.
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Picture:Antonika Chanel - Unsplash