Alternative Medicine and Your Health Insurance
The current healthcare system is a pain. It costs too much, is ineffective, and often unhealthy. There has to be a better way. And there is, in the form of alternative medicine.
Many people want this number to be higher and engage in this form of treatment, but have been restricted due to lack of coverage available in the form of insurance. Insurance companies are laggards and have declared that many types of alternative medicine treatments do not meet their strict scientific standards.
Complementary and Alternative Medicine
Complementary and alternative medicine (CAM) is becoming more popular as every year passes. However, receiving treatment in this fashion is still not ‘mainstream’ enough for insurance companies to accept and offer sufficient coverage for treatment.
CAM is an umbrella term for non-conventional medical care. Antibiotics, vaccines, and surgery are ‘modern medicine.’ Acupuncture, massage therapy, and naturopathy are ‘alternative care.’ The basic difference is a matter of the philosophical paradigm that has been set forth by predecessors.
Alternative medicine has many names:
- New age
The Cost of Alternative Medicine
In 2007, the most recent data available, Americans spent $33.9 billion out-of-pocket on alternative care. This accounted for over 11 percent of all personal expenses on healthcare. This number is likely to be much higher in 2018.
If you want alternative treatment, you are going to have to shop around and find a health insurance plan that has the best possible coverage care and cost. In the current state of affairs, this is going to be a challenge.
Am I Insured for Alternative Medicine?
Insurance companies are data driven and do not fully believe that the body has the ability to heal itself naturally through lifestyle modifications and naturally occurring medicines. Another fancy way of saying they often won’t cover it.
However, you may be lucky and already have a plan that has some sort of alternative medicine option available to you. While health insurance is currently in a flux of change, the Affordable Care Act decreed that insurers cannot discriminate against licensed insurers.
This includes alternative care, but it doesn’t mean that insurers are required to cover alternative medicine care. They can and do still limit the coverage for ‘experimental’ or ‘unnecessary care.’
This is a major flaw and loophole that permits insurance companies to deny coverage due to “lack of science.” Alternative care is relatively new, and has purposely been left to stay that way, for the time being.
How to Find Out if Alternative Care is Covered
If you wish to get into alternative care (CAM), analyze and study your policy. Like mentioned above, most insurance companies will only cover ‘medically necessary’ treatment. Again, alternative medicine can be argued to be unnecessary in the current state of our healthcare system and you may be denied coverage.
If you read your policy and aren’t sure what’s covered, call your insurer. Ask these questions:
- Am I covered for this treatment?
- Do I need a referral or prescription from my general practitioner?
- Will I have to meet a deductible or pay a copay?
- What is my “Out-of-Network” coverage?
- Do I have coverage for lab testing?
- Am I limited to a certain number of visits?
- What are some local providers in my policy network?
If you are persistent and driven to receive alternative treatment, you may persuade your insurer to cover you if it saves the insurance company money in the long-run. Mention that you have a back-pain, and that you are unable to receive insurance coverage for massages or a chiropractor. Since this type of treatment is way cheaper than surgery, you may have a case to get alternative care coverage.
What if my Alternative Care Isn’t Covered?
If this doesn’t work, you may be forced to pay out of pocket. Some doctors and providers offer cash discounts or have a scaled pricing setup to help patients paying out of pocket. In all, do not be afraid to ask around and probe for direct answers.
According to QuoteWizard’s Alternative Medicine Guide for Insurance, these are the most common options available to you:
- Massage – Insurance companies may cover massages if physical therapy and medication hasn’t helped. About 17 percent of large insurance firms cover massage therapy.
- Chiropractic – 91 percent of big insurance companies cover prescribed chiropractic care.
- Acupuncture – Treatments range between $50 and $150 per session. Only 32 percent of big insurance firms cover acupuncture.
- Biofeedback – Most insurers don’t cover biofeedback. The few that do, require a documented condition like migraines or fibromyalgia.
- Naturopathy – Insurers are more likely to cover a licensed naturopath.
- Homeopathy – Homeopathy is only covered by 11 percent of major insurers. Expect to pay for most homeopathic remedies out of pocket.
- Hypnosis – Insurers require physician authorization to cover hypnosis.
- Body movement
- Electromagnetic therapy
- Tai Chi
If more people become aware of alternative medicine types, then the demand will naturally force a higher supply of health care providers. The economics are not there yet, but if people push and advocate for it then there is a chance alternative medicine can become mainstream. It is up to everyone who cares to get involved and coerce insurance companies to jump on board and offer coverage for healthier and natural medicine treatments. Do your part and talk to your insurance company about offering coverage for your own health-related situation.
Nathan Barber is a Content Specialist for QuoteWizard, a home insurance comparison website. When he is not writing about insurance, you can find him with his husky/corgi or on the soccer pitch.