Alternative Medicine’s Insurance Questions Answered

by Frank Abbott

More and more Americans are now looking for new methods of treatment other than what is offered through traditional Western Medicine for their health concerns. To meet this increasing demand, insurance companies are offering coverage for a variety of “alternative” therapies.

Some of these HMOs and insurance providers include Aetna, Medicare, Prudential and Kaiser Permanente. The therapies they most often cover are chiropractic, massage therapy and acupuncture and naturopathic medicine. Herbal remedies, homeopathy, meditation and mind-body stress management are also finding increasingly more coverage.

In spite of the increased acceptance, however, payment for the services is quite limited. Insurees typically pay for the services on a discounted basis or they are allowed a very limited number of visits.

As a result of the limitations, alternative therapies are assumed to be ineffective. Practitioners would argue that they aren’t given sufficient time to complete the recommended treatment thus shortchanging the patient on outcomes.

As far as payment for most alternative therapies, patients usually have to pay for services themselves. There are some plans that offer limited coverage. These plans vary and differ from state to state. You can search yourself if you want to know if there are laws in your particular state that cover a certain therapy. For instance, if you’re interested in acupuncture, contact their national professional association because they usually watch for changes in coverage with insurance companies.

If you already have insurance but you’re unsure about coverage, check your policy thoroughly. Check to see if they offer any kind of coverage for complementary or alternative medical treatments. If you find that you have coverage, then check to see what limitations you might have. For instance, does the treatment have to be administered by a medical doctor or a practitioner “in-network”. If you’re still unsure, then contact your insurance first before getting any treatment.

Before calling your insurer, consider asking some these questions.

* Do I need to get pre-authorization before receiving treatment?

* Do I need to go to my primary care physician to get a referral before seeking treatment?

* What services are covered?

* How much is my co-payment?

* How many visits are covered per year?

* Are there limitations on the service (i.e. only covered for certain conditions)?

* Am I limited to only “in-network” providers?

* If so, what is covered if I go “out-of-network”?

* Is there a maximum for coverage?

Be certain to keep all of your records in a safe place and very organized. Make sure you maintain details of whom and when you speak to a representative for your insurance company should there be any complications with coverage in the future.

About the Author: