American Health Care

About a third of American adults use some form of complementary or alternative

medicine, according to reports by the National Center for Health Statistics. We
spend more than $30 billion a year out of pocket on everything from fish oil
supplements to acupuncture.

However, despite those billions of dollars spent annually on alternative medicine

and complementary treatments, most of these services are not currently covered by
the majority of health insurers.

The majority of those out-of-pocket expenses — $14.7 billion in the most recent
year studied — went to complementary and integrative health practitioners such as
chiropractors, acupuncturists, and massage therapists. We spent another $12.8
billion on natural products, and $2.7 billion on self care approaches, such as
wellness books and homeopathic medicines.

Despite billions of dollars spent annually on alternative medicine, most of these

services are not currently covered by the majority of health insurers… health
insurance companies still regard most alternative techniques with uncertainty.

According to the National Institute of Health, treatments that are more commonly
covered by insurance include chiropractic, acupuncture, and massage therapy.
However, health insurance companies still regard most alternative techniques with
uncertainty. Treatments that are not included in most traditional health plans
include herbal therapy, homeopathy, applied kinesiology, and naturopathy. Though
these procedures may not be covered, alternative healthcare costs could be reduced
if policyholders better understood insurance policies and options.

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Although some alternative procedures and products are now covered by insurance,
there are still many limitations placed on them when it comes to costs. Ultimately,
limited coverage can mean limited benefits for the patient.

One option for obtaining coverage for alternative medicine costs is through a
Health Savings Account (HSA). HSAs are available to individuals with high-
deductible healthcare plans who don’t receive additional coverage (including
Medicare). Money deposited into this account is tax deductible and tax-free when
used for medical purposes; this enables account holders to undergo periodic medical
evaluations, receive immunizations, and obtain screenings for cancer, heart
disease, infectious diseases, and other conditions. Additionally, the extra savings
can help policyholders avoid the financial stresses of any health insurance
loopholes of a high-deductible plan.

Another option is a Flexible Spending Arrangement (FSA). Money placed into an FSA
is pre-tax, but it must be used by year’s end for health care costs. FSA funds may
sometimes cover certain alternative services, such as hypnotherapy, acupuncture,
and chiropractic care, as well as programs that aid in addiction recovery.

The Best and Worst Alternative Care Coverage

Many individuals with health insurance plans have found that ‘approved treatments’
are only partially covered, causing them to incur sizable out-of-pocket expenses.
Prior to receiving CAM treatment, patients should meet with their insurer to
discuss certain aspects of their current health coverage.

Does the provider accept the current insurance plan?

Is it necessary for the provider to be part of the plan’s network?
What additional costs will be covered (supplements, tests, supplies, etc.)?
According to a recent article co-authored by U.S. News & World Report and Duke
Medicine, the optimal health care plan for most individuals includes integrative
medicine. Defined as a combination of traditional medicine and alternative therapy
that achieves the best possible results for any given patient, integrative
techniques include acupuncture, bio-field therapies, guided imagery, hypnotherapy,
and yoga. While the article notes that most integrative techniques are not covered
by traditional health plans, patients should meet with insurance representatives to
determine the extent of their coverage.

Some health insurance providers cover various natural supplements and alternative
therapies. Dr. Tyler Woods of eMaxHealth writes that Aetna offers a 15% discount on
more than 2,400 natural products and services, including herbal supplements,
aromatherapy, and homeopathic remedies. Kaiser Permanente is another example; the
Oakland-based firm recently began offering coverage for acupuncture, chiropractic
care, and other CAM treatments.

Before purchasing an insurance plan with alternative healthcare options, patients

should shop around to find a provider that caters to their specific needs.
Important considerations include:

Which forms of alternative medicine are considered ‘alternative’, and which ones
are not?
Does the plan cover alternative medicine for all existing needs of yourself and
family members?
What limits are placed on the costs or alternative treatments for each need?
Do practitioners of alternative medicine need to be in the network? If so, are they
nearby?
Get More Out of Your Current Plan
Concerning the patient’s payment options for integrative medicine, some employers
offer health care reimbursement accounts. This type of system will often pay for
services rendered by alternative care specialists, but a plan that includes
alternative care will generally cost more.

According to Health.com contributor Jeanne Lee, patients can receive insurance

coverage for CAM health care expenses by obtaining a prescription for these
services from their primary physician. This prescription must include the
diagnosis, as well as frequency and length of the necessary treatment. While this
measure will not guarantee coverage, many insurance provider’s will approve all
doctor-approved physicians. The most commonly approved services include
chiropractic care, massage therapy, and homeopathy.

Another approach, Lee notes, is to meet with insurance representatives to discuss

the relatively low cost of alternative treatments compared to conventional
medicine. For this reason, patients who receive CAM services should always obtain a
receipt from their health care provider(s); an alternative treatment that costs
$300 will appear considerably more attractive to insurance companies than a $15,000
conventional procedure that addresses the same medical condition.

Finally, Lee encourages patients to seek out affordable health care providers if
alternative expenses are not covered by their insurance plans. Many colleges and
training centers offer discounted services for acupuncture, chiropractic care,
naturopathic medicine, and other CAM-related practices. In many cases, these
consultations will cost between $10 and $60.