Insurance Coverage of Complementary
and Alternative Medicine (CAM)

As more and more people turn to alternative, nontraditional health therapies, insurance companies are beginning to extend coverage to at least some of these practices. In 1993, a study reported in the New England Journal of Medicine stated that almost one third of Americans had tried unconventional medical therapies, such as acupuncture, chiropractic, massage, etc. The study focused attention on the problem of insurance coverage of alternative medicine, and provided an impetus for insurance companies to begin to address the issue.

On both coasts we see insurance companies taking the lead in expanding coverage to include what is being referred to as "complementary and alternative medicine" or CAM. Here are a few of them:

Oxford Health Plans

• covers acupuncture, massage therapy, chiropractic, yoga instruction , naturopathy

• available in New York, New Jersey, Connecticut, New Hampshire, Pennsylvania

Kaiser Foundation Health Plan

• covers acupuncture, acupressure, biofeedback, nutritional information

• available in Northern California

Bienestar Gold

• offers supplemental coverage for alternative therapies offered by providers on its network; subscribers get complementary care at preferred rates.

• available in New York, New Jersey, Connecticut; moving into southeast, northeast, west coast, and midwest.

In researching this topic on the Internet, I came across an interesting website of an innovative association called the Alliance for Natural Health. I became intrigued so I decided to call them on the phone. I discovered that the Alliance, located in Hammond, Indiana , is the first company in the country to offer coverage for alternative therapies to anyone, regardless of where they live. (As a member of the alliance, you will also receive an informative newsletter on alternative health topics and discounts on herbs and vitamins.) When I exclaimed over the list of what is covered by the insurance program (acupuncture, alternative birthing centers & midwives, ayurvedic medicine, bodywork & massage therapy, biofeedback, chelation therapy, chiropractic, colon therapy, herbal medicine, homeopathic remedies, homeopathy, naturopathic medicines, oriental medicine, and osteopathy) Mr. Lee, a representative of the association, said, "Well, isn't it about time?" I had to agree. For more information they can be reached at: PO Box 4035, Hammond, IN 46324; (708) 974-9373; their web address is: <www.alternative-insurance.com>

As insurance companies move to cover CAM, the question of credentials for these therapies arises. According to John Weeks, executive editor of a newsletter entitled, Alternative Medicine Integration & Coverage, some of the problems with credentialing MD's who want to incorporate alternative therapies in their practices are: 1. Most conventional medical education does not cover complementary therapies and clinical training is virtually non-existent; 2. conventional providers are not tested in CAM (conventional and alternative medicine) as part of their examination process prior to attaining licenses; 3. CAM may not be covered by standard malpractice policies. As various academic medical centers, health systems, hospitals and medical societies begin to offer courses on various alternative therapies, the question of uniform standards becomes confusing, especially since most of these courses do not have an independent review board overseeing them. According to an article in the May issue of Alternative Medicine Integration & Coverage, the two national physician education organizations are stepping up efforts to develop standards in CAM educational programs. The Society of Teachers of Family Medicine (STFM) and the American Association of Medical Colleges (AAMC) are working on curriculum guidelines. Establishing uniformity in curriculum for educational programs will make it easier for insurance companies to have some basis for credentialing MD's to practice complementary and alternative therapies as part of their conventional practice.

It is exciting for those of us who value alternative therapies to see progress towards insurance coverage of these practices. There is still a long way to go before it becomes the norm, but at least we're moving in the right direction. If you want to help, communicate your desire for coverage of CAM with your insurance company.

Return to the Index of Synapse 44, Summer 1998