Health Insurance and Medical Herbalist Coverage

By | February 18, 2014

health insuranceMedical herbalism is a form of medicine that is becoming increasingly popular and will continue to do so well into the future. This form of medicine is all natural using either plants or extracts from plants to cure many different ailments. The medical herbalist is the professional trained to practice this type of medicine.

The cost is significantly less than traditional prescription medication and the side effects are fewer. Health insurance carriers are increasingly providing coverage for medical herbalist treatments because they are slowly beginning to realize the benefits and cost savings that can be passed on to their clientele.

What Medical Herbalists Do

Insurance companies such as Aviva recognize medical herbalists for their training and skill in applying herbal remedies to patients. They take this approach with four strategies:

• Consulting with the patient
• Physical examination
• Prescribing the remedies
• Follow up

Consulting with the patient for the first time involves getting a detailed medical history as well as a case history. The patient will be asked many questions to include current lifestyle so that the herbalist can get a total picture.

The physical examination is like any other that would be administered in a traditional medical facility. It involves checking blood pressure, lungs, heart, ear, nose and throat.

After the consultation and physical exam, the herbalist can then formulate a plan for treatment. The plan will consist of a combination of herbal remedies, diet, and lifestyle changes. The herbal remedies are actually prescribed at the clinic so as to be sure what the patient is receiving.
Follow up visits are usually scheduled every 2 to 3 weeks during the patient’s case. This is necessary so that the patient’s condition can be evaluated and adjustments can be made to the treatment plan.

It should be noted that the medical herbalist treats with the overall goal of restoring balance to the patient’s body. Herbalism falls under the belief that active pathology in a patient is the result of imbalance in the total body. However, at any time an herbalist will refer the patient to a traditional medical professional when he determines it is necessary to do so.

How Health Insurance Plays a Role

As mentioned before, health insurance carriers are beginning to recognize the potential that medical herbalists have to offer. However, most do not yet reimburse herbal treatments at 100%. There are still out-of-pocket expenses on the part of the patient.

Health insurance carriers may also provide different premium alternatives based on how much medical herbalist coverage is desired. For example, they may offer a set monetary amount back at the end of the year but only for a pre-set number of visits. Depending on the premium option, the allowed visits may be more however it is rarely covered in full. The covered individual also needs to pay for the visits up front.

What You Should Do

If you opt for herbal remedies as treatment, there are some things you should do so as to be reimbursed by your health insurance carrier:

• Find out if pre-authorization is needed to see an herbalist
• Know what services will be covered
• Know if only in-network providers are reimbursed
• Determine who files the claims

Keep a diary about everything the takes place during your case. If an insurance representative tells you that a certain herbal treatment is covered, make a note of who told you and when. Keep all documents organized and in doing so you will help your case for insurance coverage within the carrier’s allowed limits.