Insurance Coverage
Aetna & Acupuncture
Aetna acupuncture coverage - understand your benefits
Coverage Overview
Aetna covers acupuncture under most of its commercial medical plans, including employer-sponsored PPO, HMO, and EPO plans. Aetna considers acupuncture medically necessary for a growing range of conditions and has been a leader among major insurers in expanding acupuncture coverage. Nature Acupuncture & Herbs works with Aetna insurance and can verify your specific benefits.
Aetna's acupuncture coverage is generally robust compared to other major insurers. Most Aetna PPO plans allow you to see any licensed acupuncturist, in or out of network. Coverage is typically subject to your deductible and either a specialist copay or coinsurance. Visit limits vary by plan but most Aetna plans cover 20+ visits annually for eligible conditions.
What's Typically Covered
- ◈Broad list of covered medical conditions
- ◈20+ visits per year on most plans
- ◈PPO plans typically cover out-of-network acupuncture
- ◈Chronic pain, headaches, nausea, infertility, anxiety, and more
- ◈Subject to deductible and specialist copay
- ◈No prior authorization for initial course on most plans
What Aetna Publishes
Aetna publishes its acupuncture criteria in a Clinical Policy Bulletin. It considers acupuncture medically necessary for chronic neck pain and chronic headache of at least 12 weeks, low back pain, nausea of pregnancy, pain from osteoarthritis of the knee or hip as adjunctive therapy, post-operative and chemotherapy-induced nausea and vomiting, post-operative dental pain, and temporomandibular disorders. If there is no clinical benefit after four weeks the plan expects the treatment plan to be reviewed, and maintenance treatment where symptoms are neither improving nor regressing is not considered medically necessary.
Source: Clinical Policy Bulletin 0135, Acupuncture and Dry Needling. Checked September 2026.
How to Check Your Own Aetna Benefit
Plan documents are written for the plan, not for you. Two people with the same carrier on their card can have completely different acupuncture benefits, because the employer chooses the design. Anything below describes what the carrier publishes; only a call against your own member ID tells you what you have.
Before you call
- ◈Your member ID and group number, both on the front of your card
- ◈The member services phone number from the back of your card
- ◈Your date of birth and the subscriber name, if the plan is not in your name
- ◈A rough description of what you want treated, and how long you have had it
What to ask, word for word
- 1.“Is acupuncture a covered benefit on my plan, and does it need prior authorization or a referral?”
- 2.“Are CPT codes 97810, 97811, 97813 and 97814 covered, and how many units per visit?”
- 3.“How many acupuncture visits am I allowed per year, and how many have I used?”
- 4.“What is my copay or coinsurance for acupuncture, and does my deductible apply first?”
- 5.“Is a licensed acupuncturist (L.Ac.) an eligible provider type, or must it be an MD or DC?”
- 6.“Does coverage depend on the diagnosis, and which conditions are eligible?”
If it is not covered: If acupuncture is not covered on your plan, we will tell you before you book rather than after you have been treated, and we can talk through self-pay options. We also accept FSA and HSA cards.
Accepting
Aetna
Verify your acupuncture benefits before your first visit. Our billing team handles the details.
Verify My BenefitsBook AppointmentCommon Questions
Aetna Acupuncture Coverage FAQ
Does Aetna cover acupuncture?
Yes. Aetna covers acupuncture as a medically necessary service under most of its commercial plans. Covered conditions include chronic low back and neck pain, headaches and migraines, nausea, osteoarthritis, temporomandibular joint (TMJ) disorders, and certain other conditions. The number of covered visits and your cost share depend on your specific plan.
What conditions does Aetna cover acupuncture for?
Aetna has one of the broader covered condition lists among major insurers. It typically includes: chronic and acute pain (back, neck, joint), headaches and migraines, nausea and vomiting, osteoarthritis, chemotherapy-related symptoms, and post-operative pain. Some Aetna plans also cover acupuncture for anxiety, insomnia, and fertility support - check your specific Evidence of Coverage document.
Does Aetna require a referral for acupuncture?
Aetna PPO plans generally do not require a referral to see an acupuncturist. Aetna HMO plans may require a referral or prior authorization. If you have an Aetna HMO and your primary care physician refers you, we can typically obtain any required authorization on your behalf.
How do I verify my Aetna acupuncture benefits?
Call the member services number on the back of your Aetna ID card and ask about your acupuncture benefit: covered conditions, annual visit limit, deductible status, copay or coinsurance, and whether a referral is required. Alternatively, use our online verification form and our billing team will confirm your benefits before your first visit.
Other Accepted Insurance Plans
Medi-Cal
Medi-Cal acupuncture coverage - what to know
Cigna
Cigna acupuncture coverage - what's included
Blue Shield of California
Blue Shield acupuncture coverage in California
UnitedHealthcare
UnitedHealthcare acupuncture coverage - know your plan
Anthem Blue Cross
Anthem Blue Cross acupuncture coverage in Los Angeles
UMR
UMR acupuncture coverage in Los Angeles
Optum
Optum acupuncture coverage in Los Angeles
Alignment Health Plan
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UCLA Medicare (HMO)
UCLA Medicare HMO acupuncture coverage in Los Angeles
TriWest
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Premera
Premera Blue Cross acupuncture coverage for members in Los Angeles
Don't see your plan? View all accepted insurance →
Ready to Use Your Insurance?
Verify your benefits online or call our billing team - we'll confirm your coverage before your first visit.