Oregon health insurance tricky for alternative health

Oregon health insurance tricky for alternative health

Home to colleges for acupuncture, chiropractic, massage and naturopathy, Oregon has become known as a place where people embrace alternative approaches to health.

In fact, Oregon was the first state in the nation to adopt a law that prohibits insurers from discriminating against alternative health providers who are operating within their scope of practice, says Vern Saboe, an Albany chiropractor who lobbied for the bill earlier this year.

Oregon's health insurers, however, are still figuring out how to comply with the law, Saboe says: "It's a mess."

For consumers partial to alternative practitioners, the confusion has a real effect. The details of how their health plan and insurers interact with practitioners of naturopathy, acupuncture and other non-mainstream specialties will play out in the co-pays and other cost-sharing bills paid over the course of the year.

Typically, "patients have no recourse," said Laura Farr, executive director of the Oregon Association of Naturopathic Physicians. "The carriers should be covering naturopathic providers for services that they cover when other providers do them, but they don't."

So what's a consumer to do? First, when shopping for plans, drill deeper than just asking if it will cover chiropractic, naturopathy or other alternative services. What type of cost-sharing does that entail? Does it fall under the deductible? What, if any, visits are provided for free?

Many plans will cover such things, but they consider them specialty services. "What that means for the patient is they end up having to pay higher co-pays," Farr said. "Sometimes different deductibles apply."

Still, some insurers seem more open to alternative health practitioners, according to some observers.

Farr, for her part, says that Oregon's Health CO-OP has been far ahead of other insurers in welcoming naturopathic doctors as primary care physicians.

Saboe, the chiropractor, praises Oregon's Health CO-OP and Providence, and says Moda and Health Net have been good in some ways but not others.

Beth Howlett, president of the Oregon Association of Acupuncture and Oriental Medicine, said that based on a recent straw poll she ran online, Oregon acupuncturists have strong feelings about which insurers invite them in, and which do not.

"Oregon's Health CO-OP, Moda and PacificSource were mentioned over and over again," she said, adding that some Providence plans and Kaiser Permanente also received praise.

Of course, these testimonials are not as important as the specifics of your plan. And plan terms change from year to year, so it's worth checking whether your plan treats alternative care differently next year.

In response to emailed questions, all of Oregon's major insurers who sell to those buying their own coverage defended their attention to alternative health. That includes Zoom+, a new entrant into the insurance market.

The insurer's network includes naturopathic doctors "who use food, movement, and relationship as medicine," wrote Zoom executive Steve McCallion. "Our approach is to integrate traditional and alternative practice to increase health and decrease unnecessary over-medication."