Is your alternative therapy covered?

By SmartMoney

Insurers across the United States are steadily broadening coverage for health services, from alternative medicine and mental health care to elective procedures such as gastric bypasses and vision-correction surgeries.

Nearly 50% of plans included acupuncture in 2004, compared with less than 20% in 2000, according to the Kaiser Family Foundation, a health research organization.

Consumer interest is the driving force; 75% of U.S. adults have tried an alternative treatment, according to Kaiser.

For employers, offering such options not only allows them to gain employee favor, but also helps alleviate rising costs, says Etti Baranoff, an associate professor of insurance at Virginia Commonwealth University. Gastric-bypass surgery costs are insignificant compared with the lifelong health-care toll of obesity, for example, and homeopathic remedies may improve allergies for a fraction of the price of prescription medicines.

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But the bite of rising health-care costs works both ways. Options may be broader, but that doesn't necessarily mean coverage is more generous. Rather than folding new treatments in as part of their medical coverage, employers are instead opting to keep costs down by offering such treatments as supplements (much like vision or dental) or offering discount programs, says Doug Gwilliam, the president of CBIZ Benefits & Insurance, a consulting firm. By doing so, insurers can place greater restrictions on coverage -- and one misstep could leave you owing the entire bill.

What you can do

Here's how to improve your odds of getting the treatments you want covered by your insurer:

Scan your plan. Read the details of your coverage as set out in your employee handbook and your insurer's Web site. Look for limits on either the number of visits or the amount of money spent. You'll also need to find out whether you must use the entire benefit in one shot.

"If you stop the treatment, a lot of times they won't let you go back," says Rob Cola, the president of Brown and Brown Consulting, a benefits consultant.

It's also common for insurers to require that a procedure fit a specific medical need. Medicare, for example, won't cover a gastric bypass if an obese individual merely wants to lose weight. He or she must be suffering from a life-threatening disease that would mitigated by weight loss, such as poorly controlled Type 2 diabetes or advanced coronary artery disease.

Also, don't forget to check your plan for discounts on separate wellness offerings, such as visits to select chiropractors, acupuncturists, massage therapists and dietitians, as well as cheaper vitamins and homeopathic and herbal remedies.

Continued: Leave a paper trail

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