Feel free to use this page and the questions below to check your insurance coverage. It’s a good idea to keep a copy for your records, and you’re also welcome to share a copy with our front desk. Remember to give your insurance company a call at least 24 hours before your appointment. If you're checking benefits for more than one service, printing a few copies of this page might be helpful. Simply call the customer service number on the back of your insurance card, ask about your benefits or eligibility, and let the representative know you’re inquiring about your personal insurance details. 

Then ask the following:

• Do I have coverage for Acupuncture?

  • Yes/No

  • Remember: If a service isn’t covered by your insurance, we offer discounted cash rates to those who pay on the day of service.

• Is Meaningful Medicine Clinic in network with my plan?

  • Yes/No

• If we are not in network, ask: Do I have out-of-network benefits? 

  • Yes/No

• Do I have a deductible to meet first, in regard to this service? 

  • Yes/No

  • If Yes, How much is it? $ ___________

• If I do have a deductible to meet first, how much of my deductible do I still have to meet this year? 

  • $ ___________

  • This is the amount you will pay out of pocket this year before services are covered. The amount is renewed each year.

• What is the date my insurance policy renews each year? 

  • ____________

• What is my co-pay or co-insurance? 

  • ___________

• Do I have an additional copay for an office visit?

  • ___________

  • If you have a deductible, this must be met before the co-insurance applies.

• Is a referral required from my primary care physician? Is any other pre-authorization required? 

  • Yes/No ____________________________________________________________________________________

• Do I have a maximum number of visits, or a maximum dollar amount for this service each year

  • Yes/No ____________________________________________________________________________________

Write down the name of the representative that assisted you: ________________________________ 

Ask for and record a call reference number (which is how insurance companies document information provided to callers): _______________________

His/her direct phone number: ___________________________ Date/Time Called: _________________