Did you know that Medicare, our country’s health insurance for Americans aged 65 and older, effectively restricts senior citizens from seeking relief through acupuncture?

This sad truth is why the American Society of Acupuncturists (ASA) and the National Certification Board for Acupuncture and Herbal Medicine (NCBAHM) are working to educate the American public and drive change on Capitol Hill.

If you’re thinking this doesn’t apply to you because you’re still young, keep reading.

While licensing requirements and titles vary across the fifty U.S. states, I am one of over 30,000 acupuncture professionals ready to help reduce pain and improve people’s lives. While some pay out of pocket, most patients use private insurance to pay for acupuncture treatment.

However, here in Montana, once someone becomes eligible for Medicare, they essentially lose coverage for acupuncture. This is because, mind-bogglingly, licensed acupuncturists are not among those professionals currently listed as Medicare providers allowed to perform covered acupuncture services.

For reasons unclear, Medicare says: “Not all providers can give acupuncture, and Medicare can’t pay licensed acupuncturists directly for their services. You must get acupuncture from a doctor or another health care provider (like a nurse practitioner or physician assistant) who has both a:

• Masters or doctoral level degree in acupuncture or Oriental Medicine from a school accredited by the Accreditation Commission for Acupuncture and Herbal Medicine.
• Current, full, active, and unrestricted license to practice acupuncture in the state where you’re getting care.”

The statement, “Medicare can’t pay licensed acupuncturists directly for their services” is contrary to state-level regulation allowing licensed acupuncturists to practice independently without supervision by a doctor. It also tells 30,000 acupuncture professionals and would-be, future students of acupuncture that being a licensed acupuncturist is not good enough with their unfounded requirement to be both a licensed acupuncturist AND a doctor, nurse practitioner, or physician’s assistant.

Medicare covers acupuncture only for chronic low back pain, defined as “having no known cause” (for example, it’s not related to cancer that has spread, or an inflammation or infectious disease) and “pain that isn’t associated with surgery…” 

These Medicare restrictions don’t make sense in light of the fact that another federal agency, the U.S. Department of Veteran Affairs (VA), permits licensed acupuncturists to provide acupuncture care both at VA Medical Centers and in private practices. The VA promotes acupuncture as a viable alternative to opioids and, notably, recognizes acupuncture’s role in promoting whole health.

Acupuncture has also been shown to have positive effects on mental health, reducing anxiety and depression and helping to combat post-traumatic stress disorder -- ultimately improving quality of life.

According to the World Health Organization (WHO), “acupuncture remains the most common form of traditional medicine practice, with its use acknowledged by 113 Member States.”

Research on acupuncture began in the U.S. in 1976. In 1996, the Food and Drug Administration (FDA) approved the acupuncture needle as a medical device for use by licensed practitioners. Acupuncture needles are required to be sterile, nontoxic, and single use.

As outlined in the WHO’s Benchmarks for the Practice of Acupuncture (2020), there are known risks with acupuncture and ways to prevent or manage such incidents. Typically, benefits outweigh the risks, so cancer treatment centers, fertility clinics, some hospitals, national sports teams, workers compensation claim adjusters, and others recognize the healing potential of acupuncture.

After patients sign an informed consent form, they have access to a relatively inexpensive treatment option and one to which we, as a nation in financial crisis, should be increasing rather than restricting access (through Medicare and otherwise). Most practicing acupuncturists in Montana are small business owners—missing out on income potential rendering services for which we are qualified.

So why is it that Medicare is so restrictive despite popular global and national acceptance of acupuncture as a recognized and evidence-based medical practice?

If we, as a nation, truly care about working Americans as we age, then Congress will update Medicare language regarding licensed acupuncturist provider status, and expand acupuncture coverage to conditions beyond chronic low back pain.

Be on the lookout for ASA-NCBAHM’s Acupuncture for our Seniors Act and be a voice for Medicare beneficiaries—you might be one someday!   

Angie Kociolek, L.Ac. holds two Master’s degrees (one in Acupuncture and the other in Conservation Biology). She is a diplomate of the NCBAHM and a member of the Montana Acupuncture Association and ASA. She owns of Rootstock Acupuncture, LLC.