Q&A Topics

Friday, November 4, 2011 8:54:34 AM

Are alternative or non-Western treatments (chiropractic, acupuncture, Chinese medicine) covered by some health insurers but not others? Why or why not?

Alternative healing therapies including acupuncture, chiropractic care, massage, energy healing, hypnosis, biofeedback, meditation, prayer and spiritual healing have been on the rise. However, most insurance companies are reluctant to cover them.

And while some insurance companies may not fully cover a treatment like acupuncture, they may have what’s called an “affinity program” that offers discounts for going to specific acupuncturists. Similarly, other therapies (such as homeopathy, biofeedback and yoga) may not be included fully but are available at a discount through you insurer. If your health insurance company doesn't covers these alternative treatments you can pay for them out of your own pocket.

Here are the seven tips for getting alternative medical treatments:

1. Read the fine print in your health insurance plan to see what is covered under “alternative treatments.” If your insurance covers certain treatments, make sure you understand the details. How many treatments can you get? How does your insurance company pay? Who must provide the treatments? Do you need a referral from a physician? Is this alternative treatment covered based on specific conditions?

2. Call your health insurance provider to see whether your visits to an alternative therapy practitioner will be covered. If there’s something you’d like to have covered but your insurance won’t, ask why. If the company responds that there's no evidence that such a treatment works, then start researching on your own to find proof. Provide your health insurance company with your findings and see whether the insurer will change its mind.

3. Get authorization from your health care provider stating that you’ve been referred to an alternative practitioner.

4. File a claim if you received alternative treatments without authorization from your provider.

5. Write a letter to your insurer and to your employer's benefits officer requesting coverage. You can ask your co-workers to do the same. Many insurers base their coverage options on perceived demand. The results of your labor may not happen right away, but could come to fruition down the road.

6. If your health insurance provider won’t change its mind, consider switching to catastrophic or high-deductible coverage. It's much less expensive, and the money you save can go toward your choice of alternative treatments.

7. Comparison shop. If you can’t get your alternative treatments covered by insurance, you still can save money. Unlike traditional medicine, alternative medicine allows you to pick a provider based on price. Use this to your advantage and shop wisely.