You may be thrilled to hear that insurance coverage for Complementary and Alternative Care (CAM), including naturopathic medicine will now be more accessible due to the Affordable Care Act (ACA). Section 2607 of the ACA essentially says that if a practitioner is licensed in their state, insurance companies must cover the provider. At first glance this sounds wonderful but due to last minute changes with the ACA and interpretation of the law by insurance companies, many plans are still not in compliance. A new bill (SB2357) has been introduced in the Hawaii State legislature that states that insurance companies, “shall include coverage for care provided by participating naturopathic physicians practicing within the scope of their licenses for purposes of health maintenance, diagnosis, or treatment to the extent that the policy provides benefits for identical services rendered by another health care provider.”
In summary this is what plans are covering Naturopathic care to some degree:
• UHA: UHA has covered chiropractors and acupuncturists prior to this law, however they previously did not provide coverage for Naturopathic Physicians(NDS). As of 1/1/2014, UHA has stated that they will begin reimbursing NDs as participating providers. Contact your ND to find out if they are in-network, or in the process of becoming in-network with UHA.
• HMSA: If you have a new plan (not grandfathered) Naturopathic Physicians are covered as non-participating providers. HMSA will reimburse the patient directly, according to their policy. For most plans this is 70% of billable charges. Grandfathered plans may see an expansion of coverage starting in 2015.
• HMAA: Coverage depends on your plan, currently plans with coverage for in-network NDs are “Option 1 and 2” and the “EPO 2”plan.
• Kaiser: currently not providing coverage for NDs.
• Quest/Medicaid and Medicare: These plans do not provide coverage for Naturopathic Care.
• American Specialty Health (ASH): This is an additional policy that covers CAM that some HMSA and Kaiser members can sign up for. Not all ASH plans cover Naturopathic Care, check with ASH.
Although we are far from having a perfect healthcare system and accessibility to care, this is a start in the right direction. Please go to www.CoverMyND.org and send a pre-drafted letter Governor Abercrombie.
Image Credit: Joanna Tano Photography