Free Insurance Benefits Check

Please fill out the following form so that we may check your insurance benefits.  

Before filling out this form, please note the following:

-We are out-of-network with all insurance companies, so you must have out-of network acupuncture benefits in order for insurance to pay. 

-Traditional Medicare plans will NOT cover acupuncture with us.

-Some Medicare Advantage plans WILL cover acupuncture with us. The Aetna Medicare Advantage plan (that retired teachers and state workers have) sometimes does cover acupuncture - please fill out the form below if you have Medicare Advantage.

-We do not take out-of-state Blue Cross Blue Shield or Anthem plans. If you have out-of-state BCBS acupuncture benefits, we will be happy to supply a receipt which you can use to submit for reimbursement.

-We do not take any Cigna plans.

-Some plans, such as Horizon NJ Direct, some Horizon Direct Access plans, and some Aetna teachers plans, are “capped” plans which we do not accept. We are happy to bill these plans as a courtesy, but payment by the patient is expected at the time of service. Any insurance reimbursements will be made directly to the patient.

The information on this form is secure and confidential.  

Twelve Rivers Acupuncture will not share your information with 3rd parties without your consent.