Paying for healthcare can seem scary or complicated. However, it is
essential to know your healthcare coverage and potential costs so you can make
smart choices and avoid costly surprises.
Understanding your insurance policy or other ways of paying for healthcare will not only offer you financial peace of mind, but may drive decisions on where to seek treatments.
It is wise to discuss most cost and coverage questions directly with someone who best understands the details of your insurance coverage. This could be a customer service representative with your health plan or insurance company, or someone who manages healthcare benefits within your workplace.
Many health insurance companies also offer extensive web-based explanations of benefits, so logging on is also an excellent starting place.
As you begin your quest to learn more about your available coverage, consider these facts:
Most Americans' healthcare coverage is "attached to" or supplied
by a larger system, such as an employer. If your employer does not offer health
care benefits, you may have other options.
If you are disabled, over the age of 65, or have young children, you may be eligible for financial aid (such as Medicare, Medicaid, or low-cost health insurance). To learn more, visit the Centers for Medicare and Medicaid Services .
In addition, some states offer healthcare coverage. Contact your state or local health department.
Once you've learned a little about your healthcare coverage possibilities, begin digging for answers to specific questions.
Health Payment Checklist (Print )
If you have insurance, ask:
If you do not have insurance coverage for treatment, and paying the full fee each time would be difficult for you, you might ask:
If you are seeking insurance coverage for integrative therapies, you may
wish to explore financial issues at the same time you explore care options,
since cost may be an important factor in making a decision to pursue particular
treatment options. Alternatively, you may decide to explore the cost of care
and your insurance coverage after deciding which treatment you want to do.
Whatever process you choose, know that coverage for integrative therapies varies considerably between health plans and tends to be quite limited. It is estimated that consumers pay directly (out-of-pocket) for 80% of integrative therapies. Prior to receiving integrative therapies, you should ask your provider and/or your insurance company:
A limited number of insurance companies offer integrative therapy insurance coverage. Usually, the coverage is one of the following three types:
Every state has an insurance commission that regulates the insurance industry, enforces laws, and assists consumers. This agency enforces the laws governing insurance coverage of all treatments, including integrative therapies. (For example, it would enforce mandatory coverage of chiropractic  care because this is the law in all 50 states.)
If you have questions about the requirements for insurance coverage of specific integrative therapies, call the state insurance commissioner.
To locate the insurance commissioner's office for your state, go to The National Association of Insurance Commissioners (NAIC ) website. The insurance commissioner or regulator's office might have different names in different states, such as the [Name of State] Insurance Administration (or Division or Department). Each office has a toll-free consumer assistance number.
The US Department of Health and Human Services  has just launched a comprehensive health insurance search tool at healthcare.gov. Here you can find insurance options based on your situation and stay abreast of policy changes in healthcare reform.
It is important to understand your health insurance or other ways of paying
for healthcare so you don't end up with unexpected bills. Getting this
information in advance may drive decisions on where to seek treatments.
Get cost and coverage questions directly from a source that understands the details of your insurance coverage. This could be a customer service representative with your health plan, or the government website for Medicare.
If you considering integrative therapies, explore costs and insurance coverage at the beginning, since cost may be an important factor in your decision whether to do a particular treatment.
The Agency for Healthcare Research and Quality (AHRQ), a federal agency, has
helpful publications about choosing and using a health insurance plan. AHRQ
conducts research on healthcare outcomes, quality, cost, use, and access.
AHRQ's publications for consumers include "Choosing
and Using a Health Plan " and "Checkup on
Health Insurance Choices ."
Learn about your eligibility for low-cost insurance at Centers for Medicare and Medicaid Services .
NCCAM offers information on paying for complementary therapies. Get the Facts: Consumer Financial Issues in Complementary and Alternative Medicine .
The US Department of Health and Human Services  has an excellent website dedicated to explaining the new Affordable Care Act and answering questions about finding health coverage. There is also a tool to help you find what kind of coverage you qualify for and how to get it.
Where would you go to ask cost and coverage questions? Do you have a phone
number or website where you can get answers?
If you aren't sure, a place to start is with the Member Services or similar department at your health insurance company, or check out their website.
If your coverage is through Medicare or Medicaid, check out the US Department of Health and Human Services Center for Medicare and Medicaid Services website for details. The American Association for Retired Persons also offers information on Medicare.