What Are Out-of-Network Acupuncture Benefits—and Can They Be Useful?
- sarahalemilac
- 4 hours ago
- 2 min read
Short Answer: Yes! Here’s Why.
If you’ve ever looked at your health insurance and wondered what out-of-network benefits really mean—especially for acupuncture—you’re not alone. Many patients assume they’ll pay more if their provider isn’t in-network, but that’s not always the case. In fact, depending on your insurance plan, working with an out-of-network provider might be more flexible, more personalized, and even more affordable in the long run.
Here’s how it works—and why it may be worth considering.
What Are Out-of-Network (OON) Benefits?
Out-of-network benefits are part of many PPO and high-deductible insurance plans. These benefits allow you to receive care from licensed providers who are not contracted with your insurance company—and still get partial reimbursement.
If your plan includes OON coverage, you may need to:
Meet a separate deductible (though not always!)
Pay your provider at the time of service
Submit a “superbill” to your insurance for reimbursement
Example: Anthem & Aetna Plans
Many Anthem and Aetna plans include OON acupuncture benefits, and I’ve seen firsthand how patients can come out ahead financially when they use them.
Anthem (Blue Cross Blue Shield)
If you're using OON benefits with Anthem:
You pay me directly at a discounted time-of-service rate.
I provide a detailed superbill (receipt with codes) for you to submit.
Once you meet your OON deductible (if your plan has one), your insurance begins reimbursing you.
Reimbursement happens quicker with you submitting a superbill versus our clinic attempting to submit a claim; the subscriber always gets preferential treatment!
Surprising perk: Patients often end up paying less overall than if they’d used an in-network provider, where the coinsurance or copay may be based on a higher allowable charge.
Aetna (Federal & Other PPO Plans)
Some Aetna plans—like the Foreign Service Benefit Plan (FSBP)—don’t even require you to meet a deductible for OON acupuncture. They just start reimbursing!
Another bonus? As an OON provider, I’m not restricted by Aetna’s in-network coding rules, which means I can:
Customize treatments
Offer broader services
Submit codes that truly reflect the care you receive
This gives you greater flexibility in your care—and potentially better results.
Why It Might Feel Intimidating (But Isn’t)
Yes, OON insurance reimbursement can seem confusing at first. But once you understand your benefits and get the hang of submitting superbills, it becomes a simple routine.
I’m happy to walk patients through:
How to check your acupuncture benefits
What questions to ask your insurer
How to submit superbills for reimbursement
The Real Win: Personalized Care + Better Value
When you use OON benefits with a licensed acupuncturist:
You choose your provider—not your insurance network.
You may receive more personalized, thorough care.
You may save money after reimbursement—even if the upfront cost is a little higher.
If you're tired of insurance limitations or just want to understand your options better, OON care might be the empowering, cost-effective solution you've been looking for.
Want to explore your acupuncture benefits?
Contact me—I can help you check your coverage and see if OON acupuncture makes sense for your health and your budget.
