Whether Molina Healthcare covers acupuncture depends on the type of plan you have and the state you live in. Every Molina Medicare Advantage plan covers acupuncture for chronic low back pain because federal rules require it. Molina’s Marketplace plans cover acupuncture in only four states, and Medicaid coverage shifts from state to state based on what each state’s Medicaid program allows.
Medicare Advantage: Covered Nationwide for Chronic Low Back Pain
If you have a Molina Medicare Advantage plan, acupuncture is covered for chronic low back pain. The Centers for Medicare & Medicaid Services requires every Medicare Advantage plan to cover it under a national coverage determination. The pain must have lasted 12 weeks or longer, must not be linked to surgery, pregnancy, or an identifiable systemic disease, and must be nonspecific in nature. You can receive up to 12 visits in a 90-day period, with up to eight additional sessions in the same year if you are showing improvement, for a maximum of 20 treatments annually.1Centers for Medicare & Medicaid Services. Decision Memo for Acupuncture for Chronic Low Back Pain
Copays vary by plan. A 2026 Molina Medicare Complete Care D-SNP plan in California lists a $0 copay for acupuncture visits.2Molina Healthcare. 2026 Summary of Benefits – Molina Medicare Complete Care (HMO DSNP) A 2026 Molina Medicare Choice Care HMO plan, also in California, charges $15 per visit.3Molina Healthcare. 2026 Summary of Benefits – Molina Medicare Choice Care (HMO) Some Molina Medicare Advantage plans add routine acupuncture as a supplemental benefit beyond the low back pain mandate, but availability changes year to year, so check your current Summary of Benefits.
Marketplace Plans: Four States Only
Molina’s Marketplace (ACA exchange) plans cover acupuncture in just four states, each with its own rules. The company’s Complementary Alternative Medicine benefit policy, effective January 1, 2025, lays them out:4Molina Healthcare. Complementary Alternative Medicine Benefit Interpretation Policy
- California: covered for nausea or as part of a comprehensive pain management program for chronic pain.
- Illinois: covered only for diabetes-related services.
- New Mexico: covered when a participating provider determines it is medically necessary, limited to 20 visits per plan year unless prescribed for habilitative or rehabilitative purposes.
- Washington: covered with a limit of 12 visits per calendar year, no referral required. Members with a diagnosed substance use disorder have no visit limit.
Acupuncture is explicitly not covered on Molina Marketplace plans in Florida, Idaho, Kentucky, Michigan, Mississippi, Nevada, Ohio, South Carolina, Texas, Utah, and Wisconsin.4Molina Healthcare. Complementary Alternative Medicine Benefit Interpretation Policy In those states it falls under the broader category of excluded non-traditional services.5Molina Marketplace. Florida Summary of Benefits and Coverage
Cost sharing is set in each member’s Evidence of Coverage, not the general policy. One example: the Molina Clear Cost Turquoise 3 plan in New Mexico charges a $7 copay per visit with no deductible, treats acupuncture at the same cost share as a primary care office visit, and limits coverage to in-network providers.6Molina Healthcare. Summary of Benefits and Coverage – Molina Clear Cost Turquoise 3
Medicaid: Depends Entirely on Your State
Medicaid benefits are set by each state, so Molina Medicaid acupuncture coverage looks different depending on where you live.
Ohio
Ohio Medicaid covers acupuncture for seven specific conditions set by Ohio Administrative Code Rule 5160-8-51: low back pain, migraine, cervical (neck) pain, osteoarthritis of the hip, osteoarthritis of the knee, nausea or vomiting related to pregnancy or chemotherapy, and acute pain after surgery.7Ohio Legislative Service Commission. Rule 5160-8-51 – Acupuncture Services The first 30 visits in a calendar year do not require prior authorization; beyond that, prior authorization is required.8Molina Healthcare. Ohio Medicaid Covered Services List If symptoms are not improving or are getting worse, payment for continued treatment can be denied.
California (Medi-Cal)
Molina’s 2026 California Medi-Cal provider manual confirms the plan covers acupuncture, with prior approval and limitations that may apply.9Molina Healthcare. 2026 California Medi-Cal Provider Manual California law currently allows Medi-Cal acupuncture coverage to the extent federal matching funds are available. A pending bill, AB 1949, would require up to 24 visits per beneficiary per year with more allowed for medical necessity; as of mid-2026 it was in the Appropriations Committee’s suspense file.10Digital Democracy. AB 1949 Bill Tracker
New Mexico
Molina’s New Mexico Medicaid plan (Turquoise Care) does not list acupuncture as a standard covered medical benefit.11Molina Healthcare. New Mexico Medicaid Member Handbook Molina does offer a value-added “Traditional & Holistic Healing” benefit that provides up to $300 per member per calendar year toward services including acupuncture, therapeutic massage, traditional ceremonies, and curanderismo. You must complete a Health Risk Assessment to access it.12Molina Healthcare. New Mexico Medicaid Benefits
Washington
Washington Apple Health historically has not covered acupuncture, and a July 2023 Molina benefits index listed it as a noncovered service.13Molina Healthcare. Washington Medicaid Benefits Index The state Health Care Authority announced in October 2024 that coverage would start January 1, 2025 for adults 18 and older, with a 24-visit annual limit.14Washington Health Care Authority. Apple Health Acupuncture Coverage Announcement The next month, the HCA paused implementation because of state budget reduction directives.15Washington Health Care Authority. Apple Health Acupuncture Coverage Pause Announcement Check with Molina or the HCA for the current status before scheduling a visit.
Why Coverage Varies So Much
The ACA does not require Marketplace plans to cover acupuncture. The law mandates 10 broad essential health benefit categories, but states define the specific services within those categories through their benchmark plans, and only a few have added acupuncture.16WebMD. Affordable Care Act: Is This Covered17The Commonwealth Fund. Enhancing Essential Health Benefits: States Updating Benchmark Plans For Medicaid, each state decides independently, which is why Molina covers acupuncture under its Medicaid plan in some states and not in others.
How To Confirm Your Own Coverage
Plan details shift year to year and differ across product lines, so the most reliable check is your own Evidence of Coverage or Schedule of Benefits. Molina’s benefit interpretation policy states that if the general policy conflicts with your individual plan documents, your plan documents control.4Molina Healthcare. Complementary Alternative Medicine Benefit Interpretation Policy Where acupuncture is covered, services must come from licensed, in-network providers; there is no general provision for out-of-network coverage. Call the Member Services number on the back of your card to verify benefits, locate in-network acupuncturists, and find out whether prior authorization is needed before you schedule.