Insurance for Complementary and Alernative Medicine (CAM)

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Complementary and alternative medicine—also known as CAM—has been gaining ground in the United States. In 2007, the National Health Interview Survey indicated approximately 38 percent of adult Americans used CAM. The definition of CAM is difficult, because it is a very broad field. Generally, CAM is any medical therapy that is not considered mainstream or conventional medicine. These boundaries are flexible; chiropractic care was once considered quackery by many conventionally trained doctors but has moved much closer to being considered mainstream.


Alternative medicine includes therapies that most conventional practitioners regard as inappropriate or not supported by scientific research; herbal medications, dietary supplements, mind-body medicine, and energy medicine are considered alternative therapies. However, in other countries, what an American doctor may see as alternative medicine is considered part of conventional practice. Many European physicians routinely use herbal medications in place of or as an adjunct to the standard prescriptions used in the United States. When conventional medicine and alternative medicine are combined, the proper term for such practices is complementary. “Integrative medicine” is another term for the combination of alternative and conventional medicine.

One way to identify what treatments are considered CAM is to look at what a private health insurance plan will pay for. Dietary supplements and herbal medications are almost never covered by private health insurance. However, many plans will pay for chiropractic treatment—although they may limit the number of treatments within a certain time period. Some private insurance plans will pay for acupuncture but few pay for massage therapy. Most of the money spent on CAM is out-of-pocket; in 2007 Americans spent over 33 billion dollars in 12 months. About one-third of that money was paid to CAM practitioners, while the remainder was spent on CAM products such as supplements. Government insurance plans such as Medicaid and Medicare tend to be even more limited when it comes to payment for CAM, although Medicare will pay for limited chiropractic therapy.

Employer-sponsored health plans tend to follow the same payment practices as private insurance plans. Your employer may provide a health care savings account or cafeteria benefit plan that allows you to put money into an account from which you can pay for non-covered health expenses. While HSAs and cafeteria plans rarely cover dietary supplements, they may cover chiropractic, acupuncture, or massage therapy that is ordered by a doctor. Some employee plans will allow you to purchase a “rider” on your regular health insurance plans for CAM therapies. Your employer-sponsored plan may also require higher deductible payments for CAM therapies, require you to use an approved network of doctors, and place limits on the number of visits of total paid. You should contact the insurance company to ensure what it covers, whether treatments must be pre-authorized, whether there is a network, whether you must be referred, if there are limits or requirements, and what your out-of-pocket costs are likely to be. And one final note—the IRS allowed deductions for acupuncture, osteopathic, and chiropractic care as of 2007.

 

Alexandra Bryant has worked in the insurance industry for the last eight years and currently works as a finance writer.