More Medicare, Medicaid Patients Turning to Alternative Therapies?
The use of complementary and alternative medicine (CAM) is increasing in the United States. According to the National Center for Complementary and Alternative Medicine (NCCAM), about 38% of adults in the US used some form of CAM in 2007. Most of those are women with higher levels of education and income, however it appears that more patients on government healthcare plans, such as Medicare and Medicaid, are also using CAM due to frustration with access to standard healthcare.
NCCAM defines CAM as a “group of diverse medical and health care systems, practices, and products that are not generally considered to be part of conventional medicine.” Therapies include acupuncture, biofeedback, chiropractic care, diet and nutrition-based therapies, homeopathic treatment, hypnosis, massage, naturopathy, and exercises such as yoga and tai chi.
Most health insurance plans does not cover CAM, including Medicare and Medicaid, and patients must pay out of pocket. Naturopathic doctors, for example, are not eligible to be Medicare or Medicaid providers and have to charge patients “fee for service.” Even plans that offer coverage usually do so at a higher deductible cost than conventional care. Usually this is a deterrent for patients who have budget restraints.
However, budget cuts have caused a reduction in services for many Medicaid patients and due to low reimbursement rates, many doctors are opting out of the Medicare program. These patients are forced to seek care elsewhere or try other options. For example, a survey by Flexcin International of Fort Myers, Florida, a company that makes an all-natural arthritis supplement, found that in states where significant Medicaid cuts were occurring, patients were increasing their use of their over-the-counter product.
Chiropractic care is one area of complementary medicine that is gaining coverage under some health plans, including Medicare, although such coverage is usually limited. Plans either put a limit on the number of treatments one can receive or limit the procedures that are covered. Medicare, for example, will only cover manual manipulation for subluxation of the spine.
Acupuncture is another area that is increasingly gaining coverage due to the greater number of solid medical evidence that it is able to treat certain conditions and symptoms. Medicare specifically excludes treatment by acupuncture. Those states that provide coverage under their Medicaid program limit the benefits or require that coverage be provided only for treatments by a licensed physician (MD or DO).
Health insurance rarely covers the costs of other types of CAM therapies, so these become out of pocket expenses. However, some patients view a $10 bottle of nutritional supplements as preferable to a $25 physician co-pay plus the cost of a prescription, particularly when access to supplements is easier than finding a doctor who will accept a government health plan. Unfortunately, alternative medicine (that which is used instead of conventional medicine instead of as a complementary therapy) can, in some cases, be dangerous.
The National Institutes of Health offer seniors and other Americans information on choosing complementary and alternative therapies wisely. Most important is to be an informed consumer. Learn the facts about CAM therapies, including the potential risks. It is wise to present your primary care physician with a list of all of your health conditions and current medications and speak to him or her about the addition of a CAM therapy. Include a discussion of budget restraints or frustrations with healthcare access to find the group of treatments that is best for you.