Complementary and alternative medicine (CAM) is in demand among chronic pain patients. Some estimates say that at least 40% of people with chronic pain use CAM therapies such as chiropractic care, therapeutic massage and acupuncture.
Unfortunately, insurance coverage doesn’t necessarily reflect CAM’s popularity with the public. Americans spend tens of billions of dollars out of pocket every year on alternative medicine for a host of maladies including chronic pain.
If you’re looking for ways to remedy insurance coverage gaps, we can offer several suggestions. Just like CAM treatment itself, paying for alternative therapies involves some outside-the-box thinking.
Coverage gaps in alternative medicine
You might wonder, “Why doesn’t my insurance cover alternative medicine the same way?” In many cases, insurance providers regard CAM treatment as experimental, scientifically untested or medically unnecessary.
A lot of insurance plans don’t rule out alternative medicine entirely — they just don’t cover it as extensively as traditional medicine. The resulting coverage gaps add up. Health researchers have estimated that patients using complementary or alternative medicine could spend hundreds of dollars out of pocket every year, including an average of:
Levels of coverage vary widely among insurance providers, so out-of-pocket expenses for CAM chronic pain treatment can vary. If you have Medicare, be aware that the program offers very limited coverage for chiropractic care and no coverage for acupuncture.
Cost and coverage of chronic pain treatments
Here’s a list of some alternative treatments for chronic pain, along with estimated price ranges and typical scope of insurance coverage.
|Treatment||Cost per session||Visits covered per year|
|Biofeedback||$75-$200||Typically not covered without specific diagnosis|
|Naturopathy||$250-$400 for initial 90-minute visit; $100-$200 thereafter||Typically not covered except in a few states|
|Yoga||$12-$16||Typically not covered|
“Take the Sting out of Alternative Medicine Costs” — Money.com
“How Much Does Massage Therapy Cost?” — Center for Spirituality and Healing, University of Minnesota
Yoga Classes Cost — Costhelper.com Fitness
How much cost are you responsible for?
Even if your insurance plan offers partial coverage for some forms of alternative medicine, you may still have to bear part of the cost. Examples include:
- Insurance typically requires co-pays for office visits, whether CAM or traditional.
- Your CAM practitioner may recommend more visits than the yearly number covered by your insurance.
- In the case of yoga classes, out-of-pocket costs depend on your insurer. Some insurance companies may offer reimbursements for gym memberships or discounts with fitness providers.
Alternative financing for alternative treatment
If you’ve turned to alternative medicine to treat and manage chronic pain, you’ve probably had to face coverage gaps. However, you may not have considered some strategies that could offer help.
If alternative medicine has helped you find a solution for chronic pain but out-of-pocket expenses have left you owing debt, you might consider taking out a personal loan.
Options for personal loans to address medical debt include getting a loan or line of credit from your bank, your credit union or an online peer-to-peer lender. Also, a number of lending agencies specialize in health care loans, including loans focused on CAM treatments.
Personal loans are typically unsecured, meaning you don’t have to put up collateral, but the trade-off is often a higher interest rate than a secured loan. Also bear in mind that most personal loans have a fixed term ranging from one year to several years. If your chronic pain is ongoing, a different strategy could offer a better long-term solution.
Health care savings accounts
Certain financial tools could help you pay for out-of-pocket medical expenses while offering tax benefits. Ask your employer if they offer any of these health care savings accounts:
- FSA (Flexible Spending Account)
- HRA (Health Reimbursement Arrangement)
- HSA (Health Savings Account)
Remember that no medical savings account offers the best solution for everyone — as a patient, consumer, or taxpayer. Talk to your health care providers and your accountant or financial adviser before deciding on any of these options.
With help from your medical providers, you could make a case to your insurance company. Consider filing a claim for reimbursement that documents your alternative approach to chronic pain and includes input from your primary care doctor and your CAM practitioner. The relevant paperwork would include a Letter of Medical Necessity (LOMN), as well as receipts for CAM treatments, dietary supplements, etc.
Health care credit cards
You could use a medical credit card to help pay for out-of-pocket CAM expenses. Unfortunately, many of these cards charge high interest rates after a low- or zero-interest introductory period, which could prove expensive if you don’t pay them off immediately.
CAM supplements for chronic pain
Dietary supplements may help with certain types of pain and discomfort. They include:
|Turmeric||Devil’s claw root||Glucosamine|
|White willow bark||Feverfew||Ginkgo biloba|
“Can Supplements Help With Pain?” — WebMD
What do chronic pain supplements cost?
As noted above, supplements not covered by insurance could cost you hundreds of dollars out of pocket per year. However, some insurance providers offer discounts on certain natural supplements.
Can I get insurance to pay for supplements?
Although health insurance plans differ, you likely have to include supplements with other out-of-pocket costs. If you have a prescription, you could include supplements in a request for reimbursement.
Resourcefulness is required, at least for now
People suffering from chronic pain have many good reasons to consider alternative and complementary medicine. They include legitimate concerns about opioids and other powerful prescription medications.
The good news is that alternative chronic pain treatments seem to be gaining credibility with mainstream medicine. However until more insurance companies expand their coverage, patients relying on CAM for chronic pain will need to continue being resourceful.
Paying for Stages of Bariatric Care
There are many paths you can take to improving your health and wellness, and for some, bariatric surgery is the best option. Weight loss surgery, though, is often expensive and your insurance may not pay for all of the stages of bariatric care.
If you and your doctor have decided that bariatric surgery is your best option, you do have options for covering the costs.
Types of weight loss surgery
Just as there is no one-size-fits-all diet, there are multiple types of weight loss surgery to consider. These include:
|Type of Surgery||Average Cost with Insurance||Average Cost without Insurance|
Source: Bariatric Surgery Source
Is bariatric care covered by insurance?
The short answer: Not always. A number of factors go into whether or not your insurance will cover weight loss surgery and it can take 30 days to a year, depending on your insurance and your situation, to get approval.
Some of the steps you may need to complete to get insurance approval for weight loss surgery include:
Each step will need to be documented to submit to your insurance company. Failing to meet any of the required steps, such as not meeting with an approved nutritionist, could result in your insurance rejecting your request.
In some cases, you may find you meet all the requirements, but the state you live in doesn’t require insurance companies to cover bariatric surgery.
Financial alternatives for bariatric care
When insurance coverage for weight loss surgery isn’t an option, there are other financial alternatives for bariatric care you can consider.
Financing through a medical office or lender
Some medical offices may offer their own financial packages or have partnerships with lenders to offer financing for bariatric care patients. With this option, all of your care — from finances to surgery — is handled by one office. In some cases, financing through the medical office may provide other incentives, such as discounts on fees for the hospital stay or anesthesiology.
As with any financial product, though, you’ll want to compare a few options to ensure you’re getting the best rate. Depending on your credit score, you may find better terms with a private lender. Additionally, some medical offices may find that not all patients qualify for their lending options. In those cases, they may recommend another alternative, such as a personal loan.
Borrowing from friends and family
Another option is to borrow the money from friends and family. Websites like GoFundMe and social media have made it easier than ever to crowdsource funds for virtually anything. Asking for money can be tricky, though. In some cases, you may find that friends and family are more than willing to help because they know that bariatric care will improve your overall health and wellness.
Finances can be sensitive, so some people may not want to talk about it or loan money. It’s important to respect everyone’s decision so as not to strain relationships. In cases where money is being loaned, not given, make sure to agree upon repayment terms and dates in advance.
Using a personal loan
A personal loan may be the most flexible option for covering the costs of bariatric care without insurance. You can take out as little or as much as you need, and you can use it for virtually anything — pre-surgery consultations, hospital stay and surgery costs, living expenses during your recovery period, etc. Additionally, between private and online lenders, it’s easy to shop around and compare options to ensure you’re getting the best rates and terms.
You can also use a personal loan to supplement additional expenses not covered by another option. For instance, you may qualify for financing through the medical office to cover the surgery costs and then take out a personal loan to cover your living expenses during recovery. Or, you may consider reconstructive or plastic surgery for excess skin after significant weight loss. This may be considered a “cosmetic” procedure and won’t be covered by insurance but could be paid for using a personal loan.
The cost of surgery vs. the cost of life
Surgery should never be taken lightly — there are risks, and it is expensive. The cost of surgery may be high, but in some cases, it may be your best option at living a full and healthy life if your weight is life-threatening.
Before you consider surgery, make sure to discuss all of your options with your doctor:
Improving your health and wellness
After speaking with your doctor, you may determine that having bariatric surgery is the best decision for your health and your quality of life. In these cases, costs may be an issue, but know that you have options to help you cover those expenses.
Funding Post-Trauma Reconstructive Surgery
In the broadest sense, reconstructive surgery is the use of surgery to restore the form and function of the body. This could entail breast reconstruction from surgery associated with breast cancer, as well as other post-trauma injuries. Unfortunately, how these surgeries are defined and their level of necessity, and what insurance providers are willing to cover can get complicated.
Covering the cost of post-trauma reconstructive surgery
So, what are some ways to fund post-trauma reconstructive surgery? You might be surprised to learn just how many options you have…
Health insurance may seem like the most obvious route, but it can actually get tricky. This is because of the definition of reconstructive surgery that many health insurance providers tend to use and what is covered under it.
In most cases, insurance companies take their cue from the American Medical Association(AMA) and the American Society of Plastic Surgeons (ASPS). That is, reconstructive surgery is surgery performed on abnormal structures due to congenital defects, trauma, infection, disease, etc. In short, surgeries that improve your body’s regular function and restore what is deemed as a normal appearance.
These are all surgeries deemed necessary to correct your body’s basic functions to help you lead a healthy life. As a result, insurers usually will not cover surgeries deemed cosmetic for the sole sake of appearance and self-esteem. These include:
*Eyelid surgery for the purpose of eliminating crow’s feet or yielding a more youthful appearance. Surgery on eyelids that helps correct vision problems may be covered by insurers.If you’re considering reconstructive surgery, be sure and contact your insurer before making any decisions. A representative should be able to give you a clearer picture on how they’ll be able to assist you financially.
Doctor payment plan
In some cases, the doctor performing the surgery will be more than willing to work out a payment plan with the patient. Some doctors also employ patient care coordinators who can guide the patient toward an amicable payment solution.
Another perk about working out a payment plan with your doctor is that these plans usually don’t include interest. And, in most cases, your doctor will have the flexibility to develop the payment plan based on what you can pay on a monthly basis.
Just make sure you stick with the payment plan as these unpaid loans can still go to a collection agency. Furthermore, not following through on a payment plan with your doctor could negatively impact your rapport with the office moving forward.
The Medicare program may also be able to help fund post-trauma reconstructive surgery. In general, Medicare does not cover cosmetic surgery unless it’s needed for an accidental injury or to improve your body’s overall function. This is similar to how private health insurance tends to approach these situations.
Additionally, Medicare can cover the cost of breast prostheses as a result of a mastectomy. This also falls in line with correcting breast asymmetry which some health insurance providers do cover.
One important distinction to be made is that Medicare is not the same as Medicaid. Medicare is a federal program that provides health coverage to seniors 65 and older with severe disabilities and no income. Medicaid, on the other hand, is a state and federal program that helps provide health coverage to low-income families. Depending on your state, Medicaid may not cover reconstructive surgeries. Furthermore, Medicaid is not included under the Women’s Health and Cancer Rights Act (WHCRA) of 1998 – an act that stipulates that all insurers offering mastectomy benefits must provide coverage of reconstruction.
If you have decent credit, you can look into taking out an unsecured loan with your bank. One of the great things about an unsecured personal loan is that you don’t need to put up any collateral. And, if your credit is good enough, you could initiate a fixed-rate plan over a fixed amount of time rivaling what you could accomplish on credit alone.
On top of that, taking out a personal loan can also have a positive impact on your credit history. And, unlike credit cards, personal loans’ fixed amounts means you can’t add more debt to what already exists on your policy.
A credit card might serve as an affordable alternative provided the interest rates are manageable. However, you’ll want to make sure you can handle the expense of the reconstructive surgery in a timely manner. Massive purchases such as reconstructive surgery could affect your credit utilization ratio, which would have an adverse impact on your score.
Comparison: Personal loans vs. credit cards
We would be remiss if we didn’t take a closer look at those last two payment methods: personal loans and credit cards. While both can be used to help pay for post-trauma reconstructive surgery, it can be far riskier to use a credit card. There are also other factors to consider:
The bottom line
Whether you were born with a congenital abnormality or you’ve suffered a traumatic injury, you can get the surgery you need to live a full, healthy life. What we’ve gone over are just some of the ways you can fund post-trauma reconstructive surgery. Be sure and speak with your doctor before you decide on anything as they might be able to work out a payment plan with you. And, if you have health insurance, contact a representative to see if your policy covers these surgeries.