Americans spend more than $30 billion every year on out-of-pocket costs associated with complementary and alternative medicine treatments, according to the National Center for Complementary and Integrative Health (NCCIH)—a nod to both the popularity of such treatments and the lack of insurance coverage for them.
Depending on the carrier, some private health insurers may offer partial coverage for certain complementary treatments, such as acupuncture, massage, or chiropractic care. Of these three treatments, Medicare covers only chiropractic visits, so if you’re undergoing a treatment that requires multiple sessions, as acupuncture often does, you’ll likely see your costs quickly adding up.
Know before you go
Before seeking treatment, it’s a good idea to speak with your doctor to determine whether the therapy you’re considering may be beneficial for your particular needs.
You’ll also want to check with your insurance company about coverage. Medicare.gov has an easy-to-use search function that tells you whether your particular therapy is covered. The NCCIH suggests that you ask your insurance company these questions:
• Is this complementary or integrative approach covered for my health condition?
• Does it need to be preauthorized or preapproved?
• Does it need to be prescribed by my doctor?
• 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 or requirements, such as a limit on the number of visits you can make or the amount you’ll pay?
• How much do I have to pay out-of-pocket?
Keep a record of all your calls and copies of bills, claims, and correspondence from your insurance company, should you need to dispute a rejected claim. If you’re shopping around for a new plan, ask potential insurers about the complementary or integrative costs they cover or any discounts they offer for out-of-pocket costs or supplemental coverage.
If you know you’ll be paying out-of-pocket for your treatments, you may be able to set up a tax-exempt account. If you’re still working, your employer may offer a flexible spending account (FSA). An FSA account lets you set aside pretax dollars for health expenses.
If you have a high-deductible health plan, you’re retired, or your company doesn’t offer an FSA, you can set up a health savings account (HSA). An HSA lets you save tax-free money for medical expenses, and anyone can set up an account. For more information on these plans, visit the Internal Revenue Service website. Some therapies may be tax deductible, depending on how much you spend out of pocket.
Figuring out your costs
Resolve any billing questions you have with your complementary practitioner in advance of the procedure. Ask:
• Does the practitioner accept my insurance?
• Do I file a claim with my insurance company or does the practitioner submit a claim on my behalf?
• What will the costs be for the first appointment and follow-up visits?
• Will there be additional charges, such as for testing?
• Can I pay using a sliding scale, based on how much I can afford?
Read more about complementary therapies for joint pain and back pain.