Obamacare: alternative medicine is “covered”

Why hasn’t anyone thought of a health insurance plan to cover alternative medicine?  An insurance that goes outside the current health system, a separate insurance for people looking for these complementary and alternative medicine treatments?

Other Path Seeker

Dear Other Path Seeker,

Your current health insurance may cover it already.  The Affordable Care Act (“Obamacare”) requires insurers to “not discriminate with respect to participation under the plan or  coverage against any health care provider who is acting within the scope  of that provider’s license or certification under applicable state  law.” (See FAQs on provider non-discrimination.) This means that a licensed acupuncturist, for example, could be in an insurer’s network and provide services.

The actual implementation of this is difficult, however.  It comes down to procedure codes.  An acupuncturist might be licensed, but not able to bill any procedure codes that are covered by insurance.  Many experts fault the law for being vague, and for leaving the follow-through to the state regulators.

So, in theory, alternative medical care should be covered but in practice it often is not.  Some states have rules requiring specific treatments be covered by health insurance; acupuncture is a mandated benefit in 11 states, for example.  It’s worth calling your plan and finding out what might be covered.  You may be pleasantly surprised.


Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.