Is Integrative Medicine Covered by Insurance?

Imagine finding a natural treatment that works wonders for a patient’s health, only to discover it might not be covered by insurance. 

The growing popularity of integrative medicine and its intersection with traditional insurance models might leave you wondering if you can afford this highly desired form of medical care.

This article explores the complex landscape of insurance coverage for integrative medicine, offering insights for patients and providers.

Understanding integrative medicine

Integrative medicine has been increasing in popularity, as more than one-third of the population uses complementary health approaches—such as meditation, mindfulness, yoga, massage therapy, acupuncture, chiropractic care, naturopathy, and other whole person care options. 

Integrative medicine combines conventional (traditional) medicine with complementary and alternative approaches to achieve optimal patient-centered care focused on natural treatments and preventive medicine. 

There’s a growing demand for integrative medicine approaches, as much of the population enjoys non-invasive treatments. More and more doctors are implementing this approach into their practices, which begs the question: Does insurance cover integrative medicine?

Ready to start delivering better patient care? 

Join 100,000 practitioners who rely on Fullscript to dispense top-quality supplements to their patients.

Try Fullscript for free

The current state of insurance coverage for integrative medicine

Whether or not insurance companies cover integrative medicine depends on the company and the plan, as the specifics of each plan vary widely. While more and more insurance plans cover at least some complementary medicine treatments, particularly acupuncture, massage, and chiropractic therapy, 100% coverage isn’t a guarantee. 

Get in touch with an insurance company to determine which services and providers are covered. To receive insurance coverage for complementary care, some companies require a referral or note from a doctor deeming the treatment medically necessary. 

Specific integrative treatments and their insurance coverage

Specific integrative treatments are more likely than others to be covered by health insurance plans. Here are a few commonly sought-after complementary therapies.

Acupuncture

Many insurance plans cover at least part of the cost of acupuncture, and that number appears to be increasing. Studies showed an increase in acupuncture visits covered by insurance from 41% in 2010–2011 to 50% in 2018–2019.

Medicare Part B covers up to 12 acupuncture treatments in a 90-day period for chronic lower back pain. It also covers eight additional sessions if you show improvement (20 treatments in 12 months). 

Chiropractic care

Chiropractic care is a commonly used complementary treatment that many insurance companies cover a specific number of visits each year. 

Some researchers suggest that commercial, Medicare, and Medicaid insurers often cover the cost of physical therapy (98%), occupational therapy (96%), and chiropractic care (89%). Medicare Part B covers manual spinal manipulation by a chiropractor to correct spinal misalignment. 

Naturopathic medicine

Insurance coverage for naturopathic medicine is increasing in numerous US states, helping make naturopathic care more accessible. Individual insurance providers will determine which specific services are covered. Naturopathic doctors may also offer income-based sliding scales or discounted cash-pay rates.

Third-party coverage for naturopathic medicine varies by state, including minimal coverage in California to mandated coverage in Washington State. 

One study suggests the likelihood of naturopathic medicine being paid for by insurance is 64% lower than primary care.

Mind-body therapies 

Researchers suggest that mind-body therapies like yoga, meditation, and other mindfulness-based stress reduction therapies are not generally covered by health insurance providers in the United States. However, it’s still worth asking an insurance company if they cover mental health care, gym memberships, or specific mind-body therapies with a doctor’s referral. 

Navigating insurance for integrative medicine

Understanding individualized insurance policies

Understanding individualized insurance policies involves doing research before signing up for coverage, speaking on the phone with an insurance company representative, and carefully reviewing each plan’s details before choosing one that’s best. 

Communicating with insurance providers

Stay in contact with insurance providers to better understand plan benefits, clarify coverage details, or explore options for adding a preferred provider to the network. In some cases, certain treatments may be covered with a doctor’s recommendation or referral. Open communication between patients, providers, and insurers can help ensure access to the right care.

Working with healthcare providers to secure coverage

Each healthcare provider will be able to confirm whether they accept an insurance plan, which services are covered, and whether they handle claim submissions on behalf of patients. For services not covered, some providers may offer cash-pay rates.

In certain cases, coverage may be available with a provider’s recommendation or referral for evidence-based treatments deemed medically necessary.

The role of evidence-based practice in insurance coverage

Evidence-based practices are more likely to be covered by health insurance companies. 

The importance of clinical research in integrative medicine

It’s vital for continued clinical research in the field of integrative medicine, as health insurance providers are more likely to deem complementary services medically necessary if their safety and effectiveness are supported by peer-reviewed published literature. 

How insurance companies evaluate efficacy and safety

Insurance companies often evaluate safety and efficacy based on sufficient research-based evidence that an integrative medicine approach is effective for treating specific medical conditions. However, they often don’t cover such services if the research interventions are experimental, unproven, investigational, or don’t provide adequate evidence. 

The future of evidence-based integrative medicine

The future of evidence-based integrative medicine involves continued research studies that help prove the safety, effectiveness, and cost-savings potential of integrative services. The growing popularity of complementary and integrative medicine and the trend of increasing insurance coverage for these services may continue as integrative medicine research funding rises.

FAQs

Consider the following information addressing frequently asked questions about integrative medicine insurance coverage.

What types of integrative medicine are most commonly covered by insurance?

Some of the most commonly covered integrative medicine services include acupuncture, therapeutic massage, and chiropractic care. However, the specific services covered vary widely among insurance companies and plans. 

How can I find out if my insurance covers a specific integrative treatment?

Become familiar with your insurance plan coverage to know if your desired complementary treatments are covered. You can find this information in the plan description provided by your insurance company, on the insurance company’s website, or by speaking with a representative over the phone to discuss your plan’s details. Ask your doctor if they accept your insurance.

Are there insurance companies that specialize in covering integrative medicine?

While insurance providers typically don’t consistently cover all integrative medicine services, many reimburse the costs of treatments they deem medically necessary based on research. 

Insurances that may offer broader coverage include Aetna, Curative, Cigna, Blue Cross/Blue Shield, United Healthcare, Humana, Medicare, and others. However, the specific treatments covered vary by plan. 

What should I do if my insurance denies coverage for an integrative treatment?

Speak with your insurance company about adding a desired healthcare provider to its network, ask your integrative medicine provider if they accept discounted cash-pay rates for services not covered by your insurance, or consider switching to health insurance that covers your desired complementary treatments. 

If you have a health savings account (HSA) or flexible savings account (FSA), consider using this tax-free money for expenses not covered by your health insurance plan.

How’s the coverage of integrative medicine likely to change in the future?

Based on the trend of increasing insurance coverage of integrative medicine, the popularity of this form of care, and a growing number of integrative medicine research studies being published, the trend of enhanced integrative medicine coverage is likely to continue. 

Ready to start delivering better patient care? 

Join 100,000 practitioners who rely on Fullscript to dispense top-quality supplements to their patients.

Try Fullscript for free

Key takeaways

• The current state of insurance coverage for integrative medicine is that some services, particularly acupuncture, massage, and chiropractic care, are more likely to be paid for by insurance. However, not all services are covered 100% and plans vary widely from company to company and the type of plan chosen.
• Patient advocacy and continued research are critical in expanding access to integrative medicine through insurance coverage.
• Want to take advantage of the many health benefits linked to integrative medicine? If you’re a patient, it’s helpful to review various insurance policies, determine their integrative medicine coverage options, choose a plan that best matches your needs, and stay informed about policy changes affecting your coverage.