Insurance goes holistic
Patients who use acupuncture or medical massage to treat an ailment typically take a hit to the wallet—paying all the cost out of pocket.
A new insurance plan offered by Priority Health relieves some of that financial sting. MyPriority Holistic is the first plan available to Michigan’s individual health insurance market segment that covers both holistic treatments and traditional medical care.
Members who sign up for the plan are eligible for up to 20 visits a year each for medically necessary acupuncture and massage services. The patient pays a $30 copayment.
“It’s been very popular,” said Carrie Kincaid, a director of product management at Priority Health.
The plan, first offered last year, took effect in January. More than 5,000 members already have signed up.
Although unusual in Michigan, the coverage of alternative medical treatments is common in the West and Northwest. In Washington, Oregon and New Mexico it is considered “standard of care” and must be included in all health insurance plans.
Nearly 38 percent of American adults and 12 percent of children use some form of holistic medicine, according to the National Center for Complementary and Integrative Medicine.
As a patient who has received acupuncture, Kincaid supports coverage for holistic health care. She received treatment for aches and pains during a twin pregnancy. With each visit, she paid $70 out of pocket.
In addition to financial benefits, she said the new plan helps with coordination of care.
Reports from an acupuncturist and massage therapist will be sent to the patient’s primary care provider. To receive coverage, the holistic health care providers must be part of the American Specialty Health network. And the treatment must be for a qualifying medical condition, such as pain or headaches.
Creating harmony and balance
Irv Marcus, an acupuncturist in Grand Rapids, Michigan, welcomes the holistic health plan.
Although acupuncture is considered alternative medicine in much of the U.S., it is a healing system that dates back thousands of years in China.
“The goal of acupuncture and Chinese medicine is to create harmony and balance,” he said. “We don’t really separate mind, body and spirit. It’s all you.”
On a recent afternoon, he performed acupuncture on Janice Brinkehoff’s sore left knee— injured in a couple of enthusiastic cartwheels.
Soft music played as he placed the needles around the knee and in Brinkehoff’s left ear. The treatment provided a sensation that felt “almost like a nice ache,” Brinkehoff said.
“I know that sounds funny,” she said. “But it feels therapeutic, like a warm sort of pressure sensation. Almost like a release.”
Marcus explained that the needles placed around the knee help improve circulation—and healing–in the area. Acupuncture also releases neurochemicals from the spinal fluid and brain that are strong pain modulators.
“It’s endorphins,” Brinkehoff said. “Instead of a steroid shot, you give your own body a steroid shot.”
Brinkehoff began using acupuncture as a patient 10 years ago and was so impressed by the results, she later became trained as an acupuncturist.
Marcus said about half of his patients seek acupuncture to treat pain. It also is used to treat a wide range of issues, including digestive ailments, asthma, fertility, smoking cessation and stress.
“In our society, we have a lot of stress,” Marcus said. “Acupuncture can calm and relax the nervous system. The musculoskeletal system can relax and the blood vessels dilate. You have improved circulation.”
Patients with acute problems are asked to try treatment three times, he said. Those with chronic issues receive six to 12 treatments. Sessions cost $60 to $90, and most patients pay out of pocket.
“Acupuncture has become more mainstream in this country in the last 15 years,” he said. “The big thing is the cost for people who don’t have disposable income.”
Rewards for exercise
MyPriority Holistic is offered to small businesses and individuals and is available on and off the federal Health Insurance Marketplace.
It also includes access to an ExerciseRewards program. Members can receive discounts at gyms and up to $120 annually for staying active.
“Our testing showed us the people who are interested in holistic medicine tend to be people who, if they have a headache, feel a walk or sunshine or fresh air or caffeine is the right approach, instead of popping an Advil,” Kincaid said.