Why Doesn't Insurance Cover Holistic Medicine?

Holistic medicine is classified as a form of alternative treatment. According to the National Institute of Health, insurance companies may cover some alternative treatment, including chiropractic, acupuncture and massage. However, holistic medicine is not covered by most insurance companies. Other forms of alternative medicine excluded from health care plans include herbal therapy, homeopathy, hypnosis, naturopathy and yoga. Insurance providers do not cover this type of treatment because it has not been scientifically proven to be effective in treating medical conditions.

Holistic medicine includes emotional, spiritual and physical care. There are numerous techniques and approaches in holistic medicine. However, all forms stress the importance of treating the person as a whole, mind and body. While holistic medicine can also involve using conventional and alternative therapies, the primary focus is often changing one's lifestyle. For example, a holistic oncology approach to treating stomach cancer might include modifying the diet by increasing antioxidant consumption and reducing sodium intake.

If you ask your health insurance company why they do not cover holistic medicine, the most likely answer will be that there is not enough evidence to prove its effectiveness. Although people may have success with holistic treatments, healthcare providers prefer to stick with evidence-based medicine. Unless scientific evidence supports that a medicine can treat an illness or condition, it will not be approved as a form of treatment. Insurance companies do not want to pay for treatment that may or may not work. The condition could worsen, requiring more treatment. There is also a health risk associated with prescribing medicine that has not been thoroughly researched. It is important to rule out interactions with other drugs the patient may be taking and possible allergic reactions.

The National Center for Complementary and Alternative Medicine is the government agency responsible for scientific research on alternative medicine. The goal is to enable evidence-based decision making regarding the use of CAM into health care. The agency sponsors clinical trials on alternative medication to prove whether treatment is effective or ineffective. NCCAM advises the public against using any product or practice that has not been proven safe.

Although insurance companies exclude holistic medicine, the Patient Protection and Affordable Care Act could change that. Section 2607 of the act prohibits discrimination against licensed CAM providers practicing within the scope of their license. As of 2013, there is debate over how Section 2607 will be interpreted and applied by states and health insurance companies. Until there is clarification, insurance providers are required to use a good faith, reasonable interpretation of the law.