Is “Alternative Medicine” Covered Under Health Insurance?

Have you ever gotten acupuncture, or a chiropractic adjustment? If so, then you are one of the 40% of U.S. adults that use complementary and alternative medicine, also known as CAM. These days, some “ alternative medicine” is not considered all that alternative anymore, and many health insurance companies will help pay for some of these types of treatments. Data show that Americans are more willing to use CAM and pay for any associated out-of-pocket charges if these types of services are covered by their insurance policies. So if you are one of the many Americans interested in CAM, then you need to know if and how your insurance covers it. 

What Is Considered Alternative Medicine?

caucasian hands putting an acupuncture needle into someone's arm
Acupuncture is considered alternative medicine.

CAM is different from necessary medical treatments, such as antibiotics, vaccines, and surgeries. It is considered non-conventional medical care, and includes treatments like:

  • Acupuncture
  • Chiropractic Care
  • Hypnotherapy
  • Homeopathy
  • Naturopathy
  • Massage therapy 

Although these alternative medicines are considered “unconventional,” there is no denying that the number of people seeking out these treatments is on the rise. Over the years, more and more Americans have been seeing acupuncturists or chiropractors for their back, neck, or other pains, with others seeking more homeopathic approaches. Studies conducted between 2002 and 2017 show that approximately 59 million Americans spent money out-of-pocket on complementary medicine, with the number rising approximately 2-5% between 2012 and 2017. 

Seeking alternative treatments has been a growing trend for years, and has even become much more popular with practitioners. According to data in 2012, more U.S. physicians recommended CAM to their patients than they had in previous years, with more than half of office-based physicians recommending at least one CAM to their patients. The most commonly recommended types of CAM by general/family practice physicians were chiropractic/osteopathic manipulation (54.0%) and massage therapy (52.6%).

Is Alternative Medicine Covered By Health Insurance?

The short answer to this question is maybe. Under the ACA, insurers can’t discriminate against any licensed healthcare provider, including alternative care providers. Although the ACA doesn’t require insurance to cover care, there are some complementary or alternative treatments that are covered to some degree by health insurance.

a body with different pressure points/joint pains in red circles.

For example, acupuncture and chiropractic care are commonly used to treat many conditions, such as asthma, back pain, chronic pain, osteoarthritis, fibromyalgia, and more. A lot of health insurance plans will help pay for these kinds of treatments, with many plans covering up to a certain number of visits to an acupuncturist or a chiropractor. Other alternative treatments that insurance companies cover on a limited basis include:

  • Massage therapy– If you’re able to get a prescription for massage therapy, your insurance might cover a limited number of massages. 
  • Biofeedback- In this type of treatment, electrical sensors are used to create feedback that helps a patient use thoughts to create changes in the body. This mind-body technique is not normally covered by health insurance; however, some plans will cover it for certain conditions such as tension migraines or fibromyalgia. 
  • Clinical hypnosis– Insurers that cover this will require physician authorization and will cover anywhere from approximately 50 to 70% of costs, while others put a limit on the number of sessions they will cover.

Finding Out What Your Plan Covers

5 question marks in different colors
There are a set of questions that you should ask your insurer beforehand.

You can determine whether your plan covers any type of CAM by reading your summary of benefits. If a treatment is not covered, it will be listed at the end of the summary, in the section entitled “Excluded Services And Other Covered Services.” If you are unsure, call your health insurance provider and ask:

  • Am I covered for this type of treatment?
  • Is this service covered for my specific health condition?
  • Does it need to be preauthorized or prescribed?
  • Do I need a referral?
  • Does coverage require seeing a practitioner in-network?
  • Will I have to meet a deductible or pay a copay?
  • If approved, are there any limits on the number of visits?
  • How much do I have to pay out-of-pocket?

If Insurance Does Not Cover It

Some insurance companies do not cover  treatments that are considered alternative, and if yours is one of them, then you might have to pay out-of-pocket. You can ask the provider for a cash pay rate; some alternative care providers have discounts or sliding-scale pricing for patients paying out-of-pocket.

pink piggy bank with a jar that says HSA with money in it

If you have a health savings account (HSA), then you can use your funds to pay for the treatments, or you can ask your insurance company if they offer a discount on alternative medicine such as chiropractic care and acupuncture.

Another great option is to find a health insurance plan that does cover alternative care. If you cannot convince your current insurance company to cover a certain treatment, even if your doctor will write a prescription for it, then consider researching other plans in your area. 

EZ.Insure has a large team of highly trained, licensed agents who specialize in health insurance. We will provide you with your own advisor who will research all plans in your area and will tell you which ones cover alternative medicine treatment. Our agent will show you all the plans available in your area, give you all of their prices, and will help you to understand how each plan covers alternative medicine. The best part is that we will do all of this at no cost to you. All of our services are completely free! To begin comparing affordable plans that cover alternative care, simply enter your zip code in the bar above, or to speak directly to an EZ agent, call 888-350-1890.

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