Love it or hate it, Obamacare is moving forward as law, and that means you need to get in the know about health reform now. We’re here to help. Second Opinion is a weekly Q-and-A series that answers questions from San Diegans on the Affordable Care Act. Ask yours here.
Question: Will insurance policies cover integrative medicine under the Affordable Care Act?
Becki Mendia is 60 years old and lives in her daughter’s colorful, art-filled bungalow in City Heights. She lost a full-time gig with an oil company five years ago and has since worked odd jobs through a temp agency. She hasn’t been able to get back on a comprehensive health plan and hasn’t yet checked into getting covered through Medi-Cal.
Instead, she’s been paying out of pocket at low-cost clinics. But her savior – what she says has kept her in good health in recent years – is home remedies. She has a daily regimen of cinnamon, honey and coconut oil for a cough (she’s a former smoker) and swears by apple cider vinegar for digestive health.
“I’m just so thankful that there are a lot of other people before me that have been doing alternative health care and they’ve posted their (tips on the internet),” Mendia said.
Video by John Rosman, KPBS
Her research on alternative medicine has her wondering:
“There’s so much data out there that chiropractors help, acupuncture helps. Will the insurances start covering some of the alternative methods of medical care?”
The Takeaway: Acupuncture is covered.
Under the Affordable Care Act, all new health plans must provide a minimum level of care called essential benefits. According to a spokesman for the state-run health exchange, Covered California, chiropractic services and massage therapy are not considered essential, but acupuncture is if it’s used for pain and nausea management. This applies to Medi-Cal patients, as well.
The copay for an acupuncture session would be around $30, according to Covered California.
Update: The state’s rules on essential benefits do not apply to Medicare. Patients 65 or older would have access to chiropractic care under Medicare B plans, but not acupuncture.
Acupuncture typically falls under the integrative medicine category, or holistic health care. It could be argued that Obamacare’s focus on preventative care (annual check ups are free) intersects with integrative medicine’s mission to treat the whole person. For instance, insurance companies must cover wellness visits and chronic disease management, which often take the form of nutrition and fitness counseling. Mental health coverage is also required.
The Orders: Get covered.
Mendia says she wants to supplement her home remedies with regular check-ups at a doctor’s office. Because her income is less than $15,856, she’ll qualify for Medi-Cal next year. If she wants to get coverage now, she can enroll in the county’s Low-Income Health Program, which acts as a bridge for childless adults in health care limbo.
Check out last week’s question: Does mom qualify for Obamacare with a green card?
Correction: An earlier version of this article implied Mendia could enroll in Medi-Cal now. Medi-Cal won’t expand to childless adults until 2014.