Yes, NDs services are covered by private insurance companies such as Aetna, Premera, United Healthcare, etc.
Maricopa County employees can access naturopathic medicine through their insurance (Cigna). Also, individual companies who self-insure can cover NDs.
If your policy does not cover naturopathic medical services, you can try to modify your policy. Most insurance companies will write a plan to cover naturopathic medicine, but you must request the coverage, depending on if your plan is an individual plan or a group plan.
Is Naturopathic Medicine covered by insurance in NY?
Naturopaths in New York and New Jersey are not currently covered by insurance. We do accept payment via cash, credit card, health savings accounts and check. While I am not a network provider with any insurance plans, you may be able to receive reimbursement directly from your insurance company for your visit.
Alternative Medicine and Insurance Coverage
When considering reimbursement, the Affordable Care Act mandates that insurers not discriminate against licensed health care providers, including those who practice alternative medicine, such as naturopaths, and acupuncturists. But that isn’t the same as requiring coverage.
Health insurers can limit coverage they deem experimental or not medically necessary, and they often do. Aetna, for example, says it considers alternative interventions medically necessary only “if they are supported by adequate evidence of safety and effectiveness in the peer-reviewed published medical literature.”
While such things as acupuncture, biofeedback, chiropractic care and electronic stimulation may be covered under their policies, music therapy, aromatherapy, therapeutic touch massage and a long list of other interventions are not.
Even when services are covered by an insurance plan, the insurer may require a statement of medical necessity or prescription from a primary care doctor. The coverage may also provide limited visits or cover only some of the services the provider offers.
Knowing Your Coverage Details
Health insurance coverage for alternative medicine is a mixed bag, varying from policy to policy. Your best bet is to make some phone calls and ask the right questions before making an appointment with a practitioner.
1. Call your insurance company.
Ask your insurer the following questions:
- Am I covered for this treatment?
- Do I need a referral or prescription from my general practitioner?
- Will I have to meet a deductible or pay a copay?
- Am I limited to a certain number of visits?
- If the practitioner is out of network what is my deductible?
Make sure you write down who you talk to and what they say, should any coverage issues arise down the line.
2. Contact local providers.
Next, call treatment providers, making sure to discuss the insurance plans they accept and their rates. Some alternative therapies, like chiropractic care, tend to cost more for initial visits than they do for follow-up appointments. Get a good estimate of how many visits you’ll need to reach recovery or a point where returning won’t be necessary.
3. Find out about additional costs.
Ask your insurance representative and providers whether there are any additional costs you should know about. If, for example, your provider recommends that you add supplements or if your insurance company covers one treatment but not another, unexpected limitations and add-ons could come with a hefty price tag.
4. No coverage? Negotiate.
If your health insurance doesn’t cover the services you want, see if the treatment provider is willing to negotiate. Practitioners may be willing to put you on a payment plan or offer discounts to cash-paying customers.
5. Alternate pathways
The best way to get reluctant insurers to cover alternative therapies is by making a good case that your treatment is medically necessary. The simplest way to do this is to get a prescription. Ask your primary care doctor to write one that includes the diagnosis and the frequency and length of treatment. Although they may not advertise the fact, some insurers will rubber-stamp CAM treatments if they are prescribed by a physician. Some of the most frequently covered therapies include chiropractic care, massage therapy, acupuncture, herbal remedies, homeopathy, and mind-body stress management.
One patient, a woman in her mid-50s, came to an office with fibromyalgia; she had chronic pain and fatigue. She was treated by an internist, who prescribed the pain medication Lyrica, and she also saw an energy healer, an acupuncturist, and a massage therapist on staff.
WholeHealth Chicago submitted a detailed claim to the insurer that included a prescription for the CAM treatments and receipts that used standard diagnostic and treatment codes. Her insurance paid for the internist and therapeutic massage, says Rubin, although the acupuncture and energy work were denied.
Another strategy is to convince the insurance company that covering alternative treatments may save them money in the long run. Some conventional treatments for chronic back pain, for instance, cost far more (and in some cases may be less effective) than alternative options such as acupuncture and biofeedback. “To a certain extent, its playing the insurance game,” says Rubin. “I would never ask anyone to not tell the truth, but if you can make the case clearly that what is being done is clinically necessary as an alternative to pharmaceuticals or surgical procedures, the insurance company can see, ‘Gee, this treatment is $200, while medication would be $600 and surgery would be $10,000.'”
6. Get a receipt
Even if you can’t get a prescription from a physician, you should get a detailed receipt whenever you pay out-of-pocket for an alternative treatment. This will increase your chances of being reimbursed. “The receipt should include more than ‘XYZ Acupuncturist, $65.
“You need to put it in the insurance company’s language, which is ICD and CPT codes.” The International Classification of Diseases (ICD) is an internationally standardized system of codes for medical diagnoses, while Current Procedural Terminology (CPT) codes are five-digit numbers assigned to specific treatments by the American Medical Association (AMA) in order to facilitate communication between (and among) medical specialists and insurers. CPT codes exist for alternative treatments such as acupuncture, therapeutic massage, and biofeedback, and you can search for other codes by keyword on the AMAs website.
In addition to the official diagnosis and CPT codes, ask the practitioner to outline the treatment plan (the duration and frequency of visits, for example). If you do have a prescription, make sure the treatment on the receipt falls within the plan that was prescribed. Indeed, when you are choosing a practitioner, it’s always a good idea to ask if they have experience submitting insurance claims for alternative therapies.
Like most Americans who opt for alternative health care, you’ll be paying out of pocket for at least some of your costs. Knowing just how much you’ll be charged can help you budget for them ahead of time.
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