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Although pain is invisible to the eye it can change people’s lives, rendering them incapable of performing many daily tasks that others take for granted. The pain may be due to disease such as arthritis, cancer or other chronic disease or pain resulting from injury or surgery. Intractable pain can prevent people from getting a good night’s sleep, cause loss of appetite, reduce the ability to simply walk or go shopping and according to the Mayo Clinic can trigger depression in some people.

In the past, pain was consistently treated by doctors by prescribing pain medication. Many of these medications, which are still prescribed, are opioids such as OxyContin, Percocet or Vicodin among others. Opioids are highly addictive and over the past few years millions of people have become addicted to a drug initially prescribed by a doctor for a legitimate medical condition. When opioids are no longer available, people have turned to heroin which unfortunately is easily available on the street and at a considerably lower price. This chain of events is the root cause for the opioid epidemic currently sweeping the United States.

Health insurance covers prescriptions for opioid medications and other pharmaceutical painkillers. However, many patients do not want to use such drugs. Some fear the likelihood of becoming addicted and others are not willing to risk the many possible side effects.

A positive consequence of the opioid epidemic is that the medical community is now placing more emphasis on the use of natural methods of pain relief such as:

  • Cognitive behavioral therapy or ‘talk’ therapy
  • Acupuncture
  • Yoga
  • Meditation – also known as mindfulness
  • Herbal remedies
  • Hypnosis
  • Homeopathy
  • Chiropractic treatment

The concern for many patients is whether or not their health insurer will cover pain relief therapy using these natural methods. It is a legitimate concern; insurance companies are slow to recognize and cover newer forms of treatment and in some cases, consider them ‘experimental.’ So, we know most just won’t take the time to read their policies and try to make sense of the maze of confusing insurance jargon. We don’t blame you. At the least, you’ll want to call your insurance company and and find out what’s covered and what’s not. Don’t be afraid to ask questions about any parts you don’t understand, after all, you are their customer.

Negotiate with your insurance company

The good news is that more insurance companies are beginning to cover treatments using natural remedies for which they use the acronym CAM, complementary and alternative medicine. The decision on coverage is made on a case-by-case basis so it behooves all of us to be our own negotiators.

What is the best approach?

Most of us would rather sit in a dentist’s chair than negotiate with an insurance company,  but the effort is worth it. Make the case that coverage for example for cognitive behavioral therapy or chiropractic treatment is infinitely less expensive than the cost of eventual back surgery which is very expensive and not always successful. The suggestion plants the seed that use of a natural form of pain relief can save an insurance company money in the long run.

Check with your physician to find out if their practice has experience submitting claims to insurance companies for treatment using natural remedies and what their success rate has been. Ask your doctor for a prescription for the recommended treatment which should include how often it is prescribed and how long treatment is expected to last. This information is helpful to an insurance company in making their decision. Some companies equate a prescription with a treatment that should be covered.

Keep copies of all correspondence with your insurance company, both requests and responses

Whenever you pay for any alternative treatment, make sure you keep the receipt. In addition to “Chiropractic back treatment $75” use language familiar to insurance companies which includes (don’t be scared off here!)

  • ICD – International Classification of Diseases –  an international code for medical diagnoses
  • CPT – Current Procedural Terminology – five-digit numbers given to specific treatments by the American Medical Association (AMA) to expedite communication between the medical profession and insurers

There are CPT codes for alternative treatments and others are available on the AMAs website using a keyword.

Since coverage for natural remedies varies from company to company it’s a good idea to call your health insurance company before visiting a practitioner and ask the following questions:

  • Will I be covered for this treatment?
  • Will you require a prescription from my provider?
  • Is there a deductible or a co-pay?
  • Are there a specific number of visits allowed?
  • Who are the providers within my network?
  • Ask if there are any additional costs you should know about in advance

Jot down the name of the person you speak with so you can contact them again if a problem arises. Call some of your local providers to see if they accept your insurance and ask about their treatment rates.

The more you learn what’s covered and the more you negotiate, the less you’ll pay out-of-pocket as you get back on the road to good health.

Who is and Why Do We Exist?

We exist to inform and educate those suffering from temporary or chronic pain to find alternative science-based solutions free from addictive drug treatments and invasive procedures.