Although insurance coverage for alternative medicine is still fairly limited, an increasing number of companies are covering complementary therapies. Acupuncture, massage, and chiropractic care are the most commonly covered therapies, but some companies also cover treatments like herbal medicine and homeopathy.Here's how to increase your chances of getting coverage for alternative treatments:
1) Check Your Policy
If you're seeking coverage for complementary and alternative medicine, start by carefully studying your health insurance plan. Since many plans have considerable limits to their coverage, you should also call your insurance company and ask the following questions before you begin treatment:
- Does my plan only cover services determined to be medically necessary?
- Does complementary care need to be pre-authorized or pre-approved?
- Does my plan limit the conditions it will cover?
- Will I need to see a practitioner in your network?
- Is coverage available for care provided by out-of-network practitioners?
- Is there a co-payment?
2) Know Your Visit Limits
Many insurance companies restrict the number of visits that will be covered within a certain period of time. Because alternative therapies often require a series of sessions in order to complete treatment, it's important to be aware of your visit limits prior to pursuing complementary care.
3) Make a Case for Your Coverage
If your insurance company is unwilling to cover the complementary care you're seeking, consider asking your primary-care physician to give you a prescription (including your diagnosis and the suggested frequency of treatment). You can also attempt to convince your insurer that your desired complementary care is more cost-effective than such standard medical treatments as surgery and medication.
4) Talk to Your Practitioner
Once you've found an alternative-medicine practitioner who seems like the right fit for your health needs, ask up front if he accepts your insurance plan and has experience in handling insurance claims. Here are a few other important questions to include in your initial conversation with your potential practitioner:
- What are the costs of the first and follow-up appointments?
- How many appointments does someone with my condition usually need?
- Do treatments involve any additional costs, such as for tests or equipment?
- Do I file the claim forms, or do you take care of that?
Since your treatment may not be entirely covered by your insurance plan, ask your practitioner if it's possible to set up a payment schedule for your out-of-pocket expenses. In some cases, practitioners may also offer sliding-scale fees (determined by the patient's income and ability to pay for treatments).
Learn more about finding a complementary/alternative medicine practitioner.
5) Research Riders and FSAs
Some insurance companies allow you to purchase a rider (an amendment to your policy) that expands your coverage of complementary and alternative medicine.
Your employer might also offer an FSA (or "flexible spending account") that lets you set aside pretax dollars for uncovered health-related expenses each pay period. After submitting your receipts from your alternative-medicine practitioner, you'll be reimbursed for any qualifying expenses. Although eligible fees often include chiropractic and acupuncture treatments, deductibles, and co-payments, it's important to check your plan to find out which expenses qualify for reimbursement.