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There are many reasons why people might choose something different to mainstream medicine and treatment. Complementary or alternative medicine and therapies are often tried by those patients who might be unhappy with their conventional treatment plan, or by those who simply do not want to be pumped full of synthetic chemicals. It could be because they believe that alternative therapies will provide a more whole person approach that agrees with their particular values.
What Does Alternative Medicine Involve?
Alternative medicine and therapies can include things such as massage, acupuncture, meditation, aromatherapy, and homeopathy. It might also involve ointments, special teas, vitamins, and herbal remedies made from natural plant extracts.
The idea behind alternative medicine is that it is a person-centered approach designed to heal the mind, body, and spirit whereas conventional medicine typically deals with the symptoms of a specific illness only. Some people like the fact that alternative medicine is more preventative than reactive, and they believe that it can help them to avoid issues with chronic disease.
Is Complementary or Alternative Medicine Covered by Insurance?
In most cases, insurance companies do not cover the cost associated with alternative or complementary medicine, especially if the treatment has not been proven to be useful for a specific symptom or illness.
It is important to remember that the same rules and regulations that are a part of the conventional healthcare system do not apply for alternative treatments. It is because of this that most insurance companies do not cover them.
Nevertheless, despite not being covered by insurance, complementary therapies are still quite popular. In fact, according to a 2016 report by the National Center for Complementary and Integrative Health (NCCIH), Americans spent $30.2 billion on complementary treatments in 2012. This amount was not covered by insurance and included things like herbal supplements, yoga, meditation, and chiropractic services.
As more and more people are opting for complementary therapies, some insurance companies are willing to cover some of the more well-known treatments such as acupuncture, massage, hypnosis, homeopathy, and naturopathy. However, it is likely that these treatments will only be covered by insurance companies if the therapy is recommended by a doctor.
Medical coding and billing can also be an issue when it comes to alternative medicine because specific medical coding does not always exist for the treatment or remedy provided, according to the experts at Find-A-Code (https://www.findacode.com). In the case of herbal supplements for example, a generic code is used rather than a specific one. Where treatments and non-prescription herbal remedies are not covered, the cost will be fully out-of-pocket for the patient.
Before You Avail of Complementary Treatment
If you are considering alternative medicine or complementary therapies, it would be wise to speak to your insurance provider to find out what is and what is not covered. Your insurance provider will likely want to know what the treatment you are considering is and the health condition from which you are suffering.
You should ask if the specific treatment must be preauthorized or preapproved or if you need to be referred by a doctor before going ahead with it. If cover is provided, ask if you need to see an in-network practitioner. You should also inquire about out-of-pocket expenses and if there are any limitations regarding cover. It may be the case that the provider will only cover a set number of treatments per year or up to a specific amount.
Get the information in writing from your insurance company so that you have evidence of what you have been told. You might need it if the insurance provider disputes a claim you have made.
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