$33.9 billion. That’s how much adult Americans spent over a recent twelve month period on CAM treatments. These were out-of-pockets dollars. $33.9 billion!
How did the spending break down? According to a National Health Interview Survey (NHIS), we spent some $22.0 billion on self-care costs, for CAM products, materials and classes. The other $11.9 billion was spent on visits to CAM practitioners. And these billions accounted for only tiny portion – some 1.5% – of the total health care spending for that same twelve months, and about 11.2 percent of the total out-of-pocket health care spending in the US for that same period.
Most of us pay for CAM treatments on our own, out-of-pocket, without any help from health insurance. Health insurance plans do cover some CAM services, however, or cover some portion of the costs, and more and more insurance carriers are designing plans with increased CAM benefits. They are recognizing that we want access to these services and the science is starting to support some treatments. Still, we generally pay for complementary and alternative treatments ourselves; the NHIS also reported that about a third of the uninsured respondents under age 65 used CAM.
- What will all this cost? How much is the initial consult? What will follow-up visits cost? How many sessions or appointments will I be likely to need?
- Are there any additional costs? Will I have to pay for additional testing, supplements or equipment?
- Are there any payment plans or options? Can I arrange a payment plan over time? Does the practice offer a sliding-scale fee (fees based on income and ability to pay)?
- Do you accept my health insurance plan? Do you have any experience with my particular plan’s coverage for someone with my condition? How are claims taken care of? Do I file the claims, or does the practice take care of this?
- Deductibles and/or co-payments. These may be higher than those applied to conventional care.
- You may need pre-authorization or a referral from your primary care physician.
- You may be limited to an approved provider network.
- There may be limits on the number of visits or the annual dollar amount paid.
- Is this treatment covered for my health condition?
- Does this treatment need to be pre-approved or pre-authorized?
- Does this treatment need to be ordered by a prescription?
- Do I need a referral from my primary physician?
- Do I have to see an in-network provider to be covered?
- Do I have any coverage for an out-of-network provider?
- What are the limits or requirements? How many visits are covered? How much will you pay?
- How much will I have to pay out-of-pocket?
- Flexible spending account: This is an employer-offered benefit. An account is established which allows you to set aside pretax dollars each pay period to use to pay health-related expenses.
- Health savings account: This is an account that you, rather than your employer, establish to go along with a high-deductible health plan. Again, you are able to set aside funds to pay for health-related expenses on a tax-favorable basis.