Many Americans use complementary health approaches, but the type of health insurance they have affects their decisions to use these practices. In a recent study (692KB PDF), researchers analyzed 2012 NHIS data on acupuncture, chiropractic, and massage—and compared that with data from 2002. While use rates for all three approaches rose, the increase was much more pronounced among those who did not have health insurance. For those who had health insurance, coverage for these three approaches was more likely to be partial than full.
If you would like to use a complementary or integrative approach and don’t know if your health insurance will cover it, you should contact your health insurance provider to find out.
Some questions to ask your insurance provider include:
- Is this complementary or integrative approach covered for my health condition?
- Does it need to be
- Preauthorized or preapproved?
- Ordered by a prescription?
- Do I need a referral?
- Does coverage require seeing a practitioner in the network?
- Do I have coverage if I go out-of-network?
- Are there any limits and requirements—for example, on the number of visits or the amount you will pay?
- How much do I have to pay out-of-pocket?
Keep records about all contacts you have with your insurance company, including notes on calls and copies of bills, claims, and letters. This may help if you have a claim dispute.
If you’re choosing a new health insurance plan, ask the insurance provider about coverage of complementary or integrative health approaches. You should find out if you need a special “rider” or supplement to the standard plan for these approaches to be covered. You should also find out if the insurer offers a discount program in which plan members pay for fees and products out-of-pocket but at a lower rate.
General information on health plans and benefits is available from the U.S. Department of Labor.
Sources of Information on Insurers
Your state insurance department may be able to help you determine which insurance companies cover specific complementary or integrative health approaches. USA.gov provides contact information for state and local consumer agencies, including insurance regulators.
Professional associations for complementary health specialties may monitor insurance coverage and reimbursement in their field. You can ask a reference librarian for help or search for them on the Internet.
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