Looking beyond mainstream medicine to cure what ails you? Don't expect much help from your insurance plan.
Here's a summary of how several major insurers address alternative care. Be advised that exceptions and limitations are common, so you'll need to rely on the language of your specific policy.
Aetna Yoga, meditation and colonic irrigation are among the things that Aetna policies do not cover, but the insurer will pay in some cases for chiropractic services, electrical stimulation, biofeedback and acupuncture.
"All of these things that are covered have been shown to be effective in clinical trials," said William Popik, the insurer's chief medical officer.
Popik said Aetna members' usage of biofeedback, chiropractic and acupuncture each increased by 75 to 100 percent from 2002 to 2003.
Asked what might account for this rapid growth, Popik said, "All of these treatments involve the laying on of hands, involve being touched, and I think people want to be touched as part of the curative process."
This process does, however, need to advance promptly: If chiropractic care, for example, doesn't improve a patient's condition within the initial two weeks, Aetna won't continue to pay for it.
CareFirst BlueCross BlueShield "We treat [chiropractic and acupuncture] as pretty much a contractual benefit," said Russ Wilbar, senior medical policy analyst for CareFirst.
"Obviously the fact that we do cover [chiropractic] means that we consider it as legitimate as any other" type of care, said Rebecca Pearce, a product manager for CareFirst. In some cases, she said, "it's covered up to 20 visits for each diagnosis that you receive."
"Let's say that you've used up all your chiropractic care for the year," added Ranaye Weinapple, a CareFirst product director. "You can then . . . get discounts [to help you pay] for additional chiro if you want that."
This combination of covered benefits followed by discounted care -- which several insurers offer -- can be valuable, Weinapple said. "One of the employees here is on chemotherapy treatments for breast cancer, and I know she uses the acupuncture before she goes to chemotherapy," she said.
Mamsi "We've been covering both acupuncture and chiropractic services for a long time," said Deborah Robinson, a spokeswoman for Mamsi. She added that "the credentialing and certification process for those health care practitioners are the same as for any other health care practitioner in our network."
Medicare Wondering how the federal health plan for retirees views alternative medicine? Cautiously, for sure: Medicare offers only limited coverage for chiropractic services and none at all for acupuncture.
And primal therapy? Don't even ask.
-- Tom Graham
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