Is your alternative therapy covered?

Leave a paper trail. "Medical necessity" is a key term in convincing your insurer that it should cover you for alternative medicines or therapies. Having a referral, prescription or a note from your doctor goes a long way toward lending credibility to expenses such as a visit to a homeopath.

"Cosmetic surgery just because someone wants to look nice won't be covered," says Davis Liu, the author of "Stay Healthy, Live Longer, Spend Wisely: Making Intelligent Choices in America's Healthcare System."

Two additional incentives to hang on to referrals and other paperwork: Having this documentation makes your expenses eligible for reimbursement from a flexible spending account or health savings account. It also qualifies toward the Internal Revenue Service's 7.5% threshold for deducting medical expenses.

Pick the right practitioner. "It's not always the procedure that's problematic but, rather, who is providing the procedure," says Tom Beam, an adjunct professor of insurance at The American College.

Let's say you'd like regular massages to relieve chronic neck pain. Most insurers will cover that, provided an in-network physical therapist or chiropractor is performing the service. Coverage is unlikely, though, if you visit a masseuse from your local spa.

Confirm with your insurer. Even if all the details seem clear, put in a call to your insurance company before you make an appointment, CBIZ's Gwilliam advises. Otherwise, you'll have a tough time claiming coverage after the fact if you've made some sort of misstep along the way.

"You can try to hold the insurance company's feet to the fire, but they have well-calloused feet," Gwilliam says. Odds are good you won't get reimbursed.

Other common restrictions:

Alternative medicine. The most commonly covered treatments are chiropractic, acupuncture and massage therapy. These are likely to show up in your regular health plan. Less common therapies (such as Chinese herbal medicine), as well as those that are more offbeat (such as biofeedback), are more likely to show up in discount programs.

Insurers are regulated on the state level, so where you live in makes a big difference in availability. Be sure to check with your state's insurance regulator for details on coverage requirements.

Mental health. The Mental Health Parity Act mandates that insurers cannot impose annual or lifetime dollar limits on mental health services (such as regular therapy sessions or medications) that are lower than those provided for medical or surgical benefits. The law does not cover benefits for substance abuse or chemical dependency. State laws, however, are less consumer-friendly on other details.

Laser eye surgery. Few companies offer vision-correction surgery as part of their regular health plans, Gwilliam says. But corrective surgeries such as Lasik are becoming a more common inclusion in discount programs.

Video: 5 words insurance companies hate

Gastric bypass. Most insurers offer this option, although access is restrictive, says author Liu. Medicare's gastric-bypass policy sets out nearly a dozen stipulations, including a six-month supervised diet and a psychiatric evaluation before surgery.

This article was reported by Kelli B. Grant for SmartMoney.

Updated Sept. 15, 2009

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