How is acupuncture treatment

Acupuncture: when does the health insurance company pay?

When does the health insurance company pay?

Since 2007, all statutory health insurance companies have been covering the costs of classic body acupuncture - but only under certain conditions: acupuncture is a health insurance benefit for chronic pain in the lumbar spine or for knee osteoarthritis if the pain has been around for at least six months.

Patients are entitled to up to ten acupuncture sessions per case of illness, within a maximum of six weeks. In justified exceptional cases, the health insurers will also pay for up to 15 sessions within twelve weeks. Each session should last at least 30 minutes. A new treatment can take place no earlier than twelve months after completion of the last acupuncture treatment.

The health insurance will only reimburse the costs if the treatment is carried out by a qualified doctor. This means: Specialists such as internists or orthopedists are only allowed to perform acupuncture treatments if they meet certain qualification requirements. This includes training in acupuncture and in-depth knowledge in the areas of pain therapy and psychosomatics. In addition, the doctors must have a permit from the Association of Statutory Health Insurance Physicians.

If the doctor does not have the necessary professional prerequisites and approval, he may not simply settle the benefits privately for those with statutory health insurance, but must inform the patient of his claim to health insurance and refer it to another doctor with the approval.

Sessions with an alternative practitioner must be paid for by patients out of their own pocket.

Tip: Many health insurances pay for or subsidize acupuncture for other diseases or for birth preparation. For those insured in the respective fund, this is done as a so-called voluntary statutory benefit or as part of bonus programs. Acupuncture is by no means always a paid IGeL service. It is worth asking your own health insurance provider before the start of the treatment.

Tips for patients

  • Before deciding on acupuncture treatment, ask your doctor about the possible benefits of this alternative healing method compared to other forms of therapy.

  • If the doctor offers you acupuncture for a fee, it is imperative that you clarify before the start of treatment whether the health insurance company will cover the costs or pay a subsidy for your illness.

  • If you have supplementary health insurance, you should find out beforehand whether costs will be covered.

  • Before starting treatment, make sure that your doctor can actually bill the acupuncture as a health insurance benefit. You can find out from the National Association of Statutory Health Insurance Physicians which doctor in your area has the necessary authorization and qualifications.

  • If you have to pay for the acupuncture yourself, get a written explanation in advance about the costs per session and ask how many sessions are necessary.

  • Make sure an experienced therapist does the acupuncture. You can find certified acupuncture doctors in your area on the homepage of the German Medical Association for Acupuncture.

Acupuncture from asthma to smoking cessation

The IGeL-Monitor has the scientific study situation for Acupuncture for three different treatments analyzed.

  1. The IGeL “Acupuncture in Pregnancy” was rated as “unclear” because the studies did show some effects of acupuncture, but these were consistently small and the results could not be relied on due to the poor quality of the studies.
  2. The IGeL "Acupuncture for Migraine Prophylaxis" was rated as "generally positive", as numerous studies have shown that acupuncture relieves migraine pain just as well as drugs whose benefits have been proven.
  3. The IGeL on "acupuncture for tension headache prophylaxis" was rated as "unclear", as the studies showed no evidence of benefit or harm due to a lack of comparisons with drugs.

The website of the Institute for Quality and Efficiency in Health Care (IQWiG) offers, professionally secured and easily understandable, further information on acupuncture for other diseases, e.g. asthma, allergies, symptoms during menstruation, menopause or as an aid to Smoking cessation.