California and Maryland will include this coverage in its individual and small group plans.
When the Patient Protection and Affordable Care Act goes into full effect in January 2014, residents of California and Maryland will be able to purchase new health insurance policies that can include acupuncture treatments.
This coverage will be available to small group and individual plans at the online exchanges.
The announcement in Maryland came from Lt. Governor Anthony Brown in that state. He had recently been in Annapolis, where he was presiding over the state’s Health Care Reform Coordinating Council. The purpose of this group was to define the essential health insurance benefits, which were selected from among ten coverage plans that are already in existence within the state.
In Maryland, a benchmark health insurance plan was defined, matching the one state workers already receive.
A notable point – so to speak – within this plan included the coverage for acupuncture as a treatment for pain management. This was included as an element of the federal healthcare overhaul’s preventative and wellness care element.
In California, Governor Jerry Brown also recently added his signature to health insurance legislation which had been created by Assembly member Bill Monning (D-Carmel). In that state, the baseline benchmark for the coverage was set to match a plan currently in existence from Kaiser Permanente. This plan, like the one in Maryland, includes acupuncture. In this case, it is approved for the treatment of both nausea and pain.
The federal healthcare law states that limitations to the coverage of medical treatments can be no greater than those that have been adopted by the state in which they exist. For this reason, there will not be any cap on the number of annual acupuncture treatments that health insurance plans will cover. This is because the Kaiser plan being used as the benchmark does not include that limitation.
It should be noted that it is, however, up to the health insurance providers to decide on the deductibles, co-payments, physician networks and referral requirements in order to receive those services with coverage from the plan. There are some restrictions from the federal law for actuarial value and cost sharing to help to make sure that coverage remains affordable to Americans.