Should Health Insurance Cover Alternative Treatments?
Should Health Insurance Cover Alternative Treatments?
A Current Overview
September 28, 2007
SixWise.com
In the United States, 36 percent of adults are using some form of complementary and alternative medicine (CAM), according to the National Center for Complementary and Alternative Medicine (NCAM). Add in megavitamin therapy and prayer, and that number rises to 62 percent.
Many insurance companies now cover acupuncture, massage therapy and chiropractic care.
CAM therapies include alternative treatments such as:
Acupuncture
Chiropractic care
Massages
Yoga and Tai chi
Hypnosis
Meditation
Energy healing
Biofeedback
Ayurveda
Diet-based therapies
Qi gong
Reiki
Naturopathy
Chelation therapy
Folk medicine
Natural products / Megavitamin therapy
Homeopathic treatment
Most people turn to CAM because they believe it will improve their health when used in combination with conventional medical treatments, according to a NCAM survey.
Others, however, turned to CAM because conventional medical treatments did not help (28 percent) or because their conventional medicine doctor recommended it (26 percent).
The survey also found that most Americans use CAM for chronic health conditions including:
Back, neck, head or joint pain, or other chronic pain
Colds
Anxiety or depression
Gastrointestinal disorders
Sleeping problems
Does Health Insurance Cover Alternative Treatments?
A survey of 18 major HMOs and insurance providers such as Aetna, Medicare, Prudential, and Kaiser Permanente found that 14 of them covered at least 11 of 34 alternative therapies.
In fact, according to Kenneth R. Pelletier, Ph.D., M.D., author of The Best Alternative Medicine: What Works? What Does Not?, "Virtually every insurance carrier offers some form of CAM coverage -- Blue Cross and Blue Shield, Aetna, Cigna, Healthnet -- all of them."
The trend in health care is that more people are requesting alternative treatments, and health insurance companies are following suit.
"It's a very clear trend -- once they begin to offer CAM benefits, most companies tend to continue and expand and add on other services," says Pelletier.
One of the most common reasons why people seek alternative treatments is to relieve chronic pain.
However, coverage varies by state and may be limited, often allowing only a small number of sessions. Depending on your policy, the coverage may not be comprehensive, but rather just a discount on the typical costs.
Because of this, many people still pay for CAM out-of-pocket at the time of service. The alternative treatments most often covered by insurance are:
Chiropractic
Acupuncture
Massage therapy
Biofeedback
Naturopathy
Even government-backed insurance programs offer some alternative coverage. For example:
The Department of Veterans Affairs may cover chiropractic care and acupuncture.
Medicare covers chiropractic care (but does not cover "alternative therapies" including acupuncture, chelation therapy, biofeedback or holistic medicine).
Medicaid may cover some CAM, but coverage varies by state.
Americans spend an estimated $33 billion on CAM every year, making it one of the most quickly expanding segments of the health care industry. Experts agree that insurance coverage for CAM is going to follow this trend.
How do You Know if You're Covered?
If you are thinking of trying an alternative treatment, you can find out if you're covered by looking through your insurance policy. It will list CAM therapies that are covered. You can also call your agency and ask them what is covered, how much is paid, and whether or not you need a referral.
Once you find out if your insurance company covers it, you also need to make sure that the CAM practitioner accepts your insurance.
What can you do if you're not covered? Ask the CAM practitioner if they offer a sliding scale for costs, based on your income and how much you can afford to pay. At the very least, most all practitioners will develop a payment plan for you, so that you can pay off the balance over time.
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