Health

ALTERNATIVE INSURANCE PROVIDER NETWORKS


More than one-third of Americans use some type of unconventional therapy. With the increasing number of requests from members, more health insurers than ever are covering unconventional treatments. In an article in a recent issue of New Age Joumal, Jan Goodwin cited a 1995 survey which stated that 86 percent of HMOs covered some type of alternative therapy.


Despite this growing trend, however, many companies specify that treatment be carried out by licensed practitioners or approved centers, and pay for treatment. only if it i's part of a larger program, such as pain management. Another requirement some insurance companies make is that the treatment be "medically necessary," a judgment which might have to be made by a conventional physician.


Whether or not therapies offered by practitioners other than MDs or DOs are covered by insurance depends


on the state you live in and on your insurance company. If you are considering alternative therapy, make sure to consult your insurance provider first. Find out which treatments are eligible and what the reimbursement policy is. Ask whether a primary care physician's referral is necessary and how many visits are covered.


Listed below are some major alternative health care insurers:

Natural Health Union, PO Box 5167, West Hills, CA, 91308, (800) 966-8467, Fax (818) 226-9820.
Covers conventional and alternative providers. Pays up to a specified annual limit for homeopathic and herbal remedies prescribed by a licensed physician, including visits to a body worker if prescribed by a physician.


CAM Health Partners, LLC, 5672 Peachtree Pkwy., Norcross, GA 30092, (877) 588-6049, E-mail: inquiries @canihealthpartners.com.
CAM Health Partners is a national Preferred Provider Organization offering discount and managed care access to acupuncturists, chiropractors, massage therapists, naturopathic doctors, and other selected complementary and alternative medicine (CAM) practitioners. CAM Health Partners PPO network-the joint creation of its individual member's networks-is available to individuals, health plans and employer groups.


CommonWell, PO Box 910, Brookline, MA 02446. Ph: (617) 566-9355. Web address: wwwcommonwell.com
CommonWell contracts with health plans, employers and other groups to provide their members with: 1) a comprehensive, credentialed network of complementary and alternative health care providers, and 2) a 24hour call line offering pre-recorded inforination on self-care, prevention and alternative health care for specific medical problems. Both of these services are also available through some existing medical discount cards.


HHC Health, 2625 Alcatraz Ave., #303, Berkeley, CA 94705, Ph: (888) 817-5566
Offer the Health and Healing Card. Membership offers discounts on alternative/complementary health, wellness, and fitness products and services.


Mutual of Omaha, Mutual of Omaha Plaza, Omaha, NE 68175. Ph: (402) 342-7600.
Pays for participants in Dean Ornish's lifestyle heart disease reversal program. Also covers chiropractic visits and some acupuncture.


Oxford Health Plan, 48 Monroe Turnpike, Trumbull, CT 06611, Ph: (800) 889-7546, Web Address: wwwoxfordhealth.com
Oxford, with approximately one and a half million members, is one of the nation's largest managed care companies. It is the first major health insurer in the country to offer coverage of preventive medicine using alternative therapies through a credentialed network. Traditionally, insurance companies have offered limited coverage and most have not provided a formal provider network.
Oxford's alternative medicine network is comprised of acupuncturists, massage therapists, chiropractors,registered dietitians, clinical nutritionists, yoga instructors and, in Connecticut, naturopathic physicians. (Naturopaths are not currently licensed in New York or New Jersey.) Oxford Health Plans offers coverage to members in New York, New Jersey, and Connecticut.

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