Unconventional Treatment: Who Pays for ‘Other Kinds’ of Care?
Generally, coverage of alternative treatments is limited and differs depending on your state and insurer. However, most insurance plans and health maintenance organizations (HMOs) do offer coverage for services from a ]]>chiropractor]]>, and virtually all cover osteopathic physician services. Additionally, some mind-body techniques have found their way into the insurability mainstream (eg, ]]>biofeedback]]>).
What Therapies Are Considered Unconventional?
Known as complementary and alternative medicine (CAM), these therapies can be used in conjunction with or in the place of conventional medicine. The main commonality among these therapies is that they are not considered part of conventional Western medicine; indeed, many are imported from Asia, Europe, or elsewhere. However, the line between CAM and conventional medicine is not always clear. The complete list of CAM therapies is quite lengthy, but some examples can be found in the article ]]>Complementary, Alternative, and Integrative Medicine: What's What?]]>.
Who Is Using CAM?
According to the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Heath, more than one-third of US adults use some form of CAM.
History of CAM Coverage in the US
For as long as there’s been medicine, patients have had numerous healing alternatives from which to choose. Many of the most popular CAM therapies have been around for centuries (eg, homeopathy) if not millennia (eg, ]]>acupuncture]]>). In the past 15 or 20 years, however, CAM has enjoyed a resurgence of interest among US consumers, a trend that has not escaped the attention of insurers. What accounts for CAM’s renewed popularity? Some of the many factors include:
- The internet offers access to health information on general and alternative therapies, empowering consumers to seek out and embrace novel approaches to healing and wellness.
- Ever-increasing cultural diversity has influenced the demand for a variety of healing practices among immigrant populations.
- Escalating costs and decreasing patient satisfaction have encouraged many Americans to explore alternatives to what they perceive as an inefficient health care system that does not meet their standards for quality care.
When surveys discovered the number of Americans using CAM who were willing to pay out-of-pocket for services, insurers felt some pressure to include at least some of these treatments in their plans. This was despite the fact that scientific evidence did not uniformly support their effectiveness (and still does not).
Choose Your Insurer—If Not Your State—Carefully: Some Are More CAM-friendly Than Others
Coverage of CAM is largely determined on a state-by-state basis, but certain plans are more flexible than others, so don’t be shy about inquiring into your options.
As mentioned, most plans cover chiropractics and ]]>osteopathic manipulation]]>. This is because chiropractic is the third largest medical profession in the country after regular MDs and dentists, having licensure in all states. Doctors of Osteopathy (DOs) have legal standing identical to MDs in all states, as well. Acupuncture has gained licensure in many states as of late, a good example of how consumer interest can influence state regulators. Beyond these more pervasive CAM practices, some plans also cover treatments such as massage, ]]>biofeedback]]>, and even medical ]]>hypnosis]]>. One popular area of CAM that is almost never covered by insurance is dietary and herbal supplements.
When considering CAM treatment, it is important to compare the amount of your deductible to the cost of the treatment. In addition, most insurers only pay for a limited number of visits, which is usually far fewer that the number recommended for complete treatment.If you know you will be using CAM services in the future, one option is to purchase a "policy rider," which is extra insurance that covers CAM treatments. These are available from a number of reputable insurance companies.
Health Spending Accounts and CAM
Health Spending Accounts, also known as HSAs, are savings accounts specifically set aside to pay for healthcare services that are often offered outside traditional health insurance plans. And you are permitted to pay for most CAM treatments with most HSA funds. Although you are spending your own money from these accounts, the money you put in is tax deductible, which can mean great savings. For more information on the types of HSA accounts available, see ]]>Health Spending Accounts: A Compliment to Regular Insurance]]>.
Alternative Medicine Foundation
National Center for Complementary and Alternative Medicine
Canadian Interdisciplinary Network for Complementary and Alternative Medicine Research
Homeopathic Medical Council of Canada
Complementary and Alternative Medicine, American Medical Student Association. Available at: http://www.amsa.org/programs/gpit/compmed.cfm. Accessed May 16, 2006
Consumer financial issues in complementary and alternative medicine. National Center for Complementary and Alternative Medicine website. Available at: http://nccam.nih.gov/health/financial/index.htm#15. Accessed May 16, 2006.
Does insurance cover CAM treatments? American Academy of Orthopaedic Surgeons. Available at: http://www5.aaos.org/courses/cam/faq1.htm. Accessed May 16, 2006.
Final report, March 2002. White House Commission on Complementary and Alternative Medicine Policy. Available at: http://www.whccamp.hhs.gov/finalreport.html. Accessed May 16, 2006.
New York State's chiropractic law. Office of New York State Attorney General Eliot Spitzer. Available at: http://www.oag.state.ny.us/health/chirobrochure.html. Accessed May 16, 2006.
Paying for CAM treatment. National Center for Complementary and Alternative Medicine website. Available at: http://nccam.nih.gov/health/financial/. Updated August 2008. Accessed August 26, 2008.
United Healthcare website. Available at: https://www.oxhp.com/members/sell/sell.html. Accessed August 26, 2008.
The Use of CAM in the United States. National Center for Complementary and Alternative Medicine website. Available at: http://nccam.nih.gov/news/camstats/2007/camsurvey_fs1.htm. Updated December 2008. Accessed June 22, 2010.
Whorton J. Countercultural healing: a brief history of alternative medicine in America. WGBH Educational Foundation website. Available at: http://www.pbs.org/wgbh/pages/frontline/shows/altmed/clash/history.html. Accessed August 1, 2006.
Last reviewed June 2010 by ]]>Brian P. Randall, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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