"Alternative" Health Benefits

[Guest kerryb]

As a health care provider, we are looking at offering alternative health services to the community. "Alternative" is defined by us as acupuncture, massage therapy, nutrition counseling, lifestyle coaching, yoga, Tai Chi, Gi Gong, Pilates exercise classes.

How have other health plans considered things like these? Flat dollar contribution, i.e. up to $500 through the health plan or have others funded it through a 125 flex account? Our current plan excludes coverage.

thanks,

kerryb@waushosp.org

[Sandra Pearce]

We considered adding to our health plan a year or so ago; however, with costs skyrocketing the Administrative Committee of the plan didn't by adding it. This what we intended to provide: Coverage for Alternative Therapy ProvidersMassage Therapists, Naturopaths and Acupuncturists. The Plan will pay 80% of medically necessary reasonable and customary Alternative Therapy expenses, subject to the Maximum Benefits and Limitations and Exclusions of the Plan. The maximum Alternative Therapy benefit payable for any one covered individual during any one calendar year is $1,000.A doctor of medicine must make referral or recommendation for alternative therapy. It is suggested that all claims for Alternative Therapy providers be submitted with a copy of the referring MD’s prescription or recommendation. The Alternative Therapy Provider must be licensed by the state in which they practice. Treatment must meet the requirements of the Plan regarding medical necessity, must be in accordance with good medical practice, and not to improve the patient’s appearance, general health of sense of well-being.