Acupuncture: When does health insurance pay?

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Written By Kampretz Bianca

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How many acupuncture sessions can I have?

All legal health insurance companies cover the costs of classical body acupuncture, but only under certain conditions. Acupuncture is a health insurance benefit for chronic low back pain or knee osteoarthritis if the pain has existed for at least 6 months.

As a patient, you are generally entitled to up to 10 acupuncture sessions per case of illness. You can attend sessions within a maximum of 6 weeks. In justified exceptional cases, the health insurer will also cover up to 15 sessions within a 12-week period.

It is important that the needles are removed during each session remain on the skin for at least 20 minutes he must. New treatment is possible at least 12 months after completion of the previous treatment.

When will the health insurer cover the costs?

The health insurer will only reimburse the costs if the treatment is carried out by qualified doctors. This means that, for example, internists or orthopedists are only authorized to perform acupuncture treatments if they meet certain requirements.

This includes, among other things, training in acupuncture and in-depth knowledge in the areas of pain therapy and psychosomatics. Additionally, doctors must have approval from the Association of Statutory Health Insurance Doctors.

If the necessary professional requirements and authorization are not met, doctors cannot simply bill privately for the service to holders of statutory health insurance. Instead, they must inform you, as the patient, about your insurance claim. They must also refer you to another doctor who has approval.

You have to pay for sessions with alternative professionals out of your own pocket.

Good to know: Many health insurance companies also pay for or subsidize acupuncture for other illnesses or to prepare for childbirth. This is then a so-called voluntary legal benefit or takes place as part of a bonus program. Acupuncture is not always a paid IGeL. It’s best to ask your health insurance before starting treatment.

What should I consider as an acupuncture patient?

  • Before deciding on treatment, ask your doctor about the possible benefits of this alternative healing method compared to other forms of therapy.
  • If the practice offers you paid acupuncture, clarify in advance whether the health insurer will cover the costs of your illness or pay a subsidy.
  • If you have supplementary health insurance, you should also ask in advance whether it covers the costs.
  • Before starting treatment, make sure the practice is actually authorized to bill for acupuncture as a health insurance service. You can find out from the Association of Statutory Health Insurance Doctors in your federal state what practices meet the necessary requirements in your area.
  • If you have to pay for acupuncture yourself, get written information about per-session costs in advance and ask how many sessions are needed.
  • Make sure experienced therapists perform acupuncture. You can find it on the home page of the German Medical Association for Acupuncture Board-certified acupuncture doctors in your area.

Acupuncture from Asthma to Smoking Cessation

O IGeL Monitor There is a scientific study available Acupuncture for three different treatments analyzed.

  1. The IGeL “Acupuncture in Pregnancy” was rated as “unclear” because although the studies showed some effects of acupuncture, these were consistently small and the results were unreliable due to the low quality of the studies.
  2. IGeL “Acupuncture for Migraine Phrophylaxis” was rated “Tends to Positive” because numerous studies have shown that acupuncture relieves migraine pain as well as medications whose benefits have been proven.
  3. The IGeL on “Acupuncture for Tension Headache Prophylaxis” was classified as “unclear” because studies showed no evidence of benefit or harm due to a lack of comparisons with medications.

The website Healthinformation.de from the Institute for Quality and Efficiency in Healthcare (IQWiG) offers – professionally backed and easy to understand – more information about acupuncture for other conditions such as asthma, allergies, problems during menstruation, menopause or as an aid to quitting smoking.

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