If you’ve ever paid for acupuncture, chiropractic care, or massage therapy out of your own pocket, you’re far from alone. The complementary and alternative medicine (CAM) market in the United States alone is worth roughly $30 billion a year, yet most of that spending comes directly from patients rather than their insurers. That gap between what people want and what plans pay for is growing as more patients look for holistic options. Understanding why some therapies get covered and others don’t — and where the exceptions lie — can save you hundreds of pounds or dollars a year in unexpected costs.
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This article is general information only and does not constitute professional advice. For your specific situation, consult a qualified professional.
Insurance companies decide what counts as “medically necessary” based on research standards that most alternative therapies struggle to meet. Conventional drugs must pass double-blind randomised controlled trials to reach the market, but many CAM approaches — herbal medicine, naturopathy, traditional Chinese medicine — rely on older or less-standardised evidence. That doesn’t mean they don’t work. It means the bar for insurer approval is higher than most patients realise. The result is a patchwork where chiropractic care is almost universally covered while herbal treatments get little to no reimbursement, and acupuncture sits somewhere in between depending on where you live and who you’re insured with. Here’s what you actually need to know.
What counts as alternative medicine and what doesn’t?
The term “complementary and alternative medicine” covers everything from acupuncture and yoga to hypnotherapy and light therapy. Insurers draw a sharp line between therapies that have enough clinical evidence to be considered medical necessity and everything else they classify as “wellness” or “experimental.”
This distinction explains why chiropractic care — backed by decades of research and licensed providers in every state — is covered by nearly all major plans, while herbal medicine, which lacks the same trial structure, rarely is. The National Center for Complementary and Integrative Health publishes detailed guidance on paying for these approaches, but the short version is this: if a therapy hasn’t been proven effective in a format insurers recognise, you’re probably paying out of pocket.
Coverage rates by therapy type and what they cost you
Not all alternative therapies face the same barriers. Some have crossed into mainstream acceptance, while others remain almost entirely outside insurance. The table below shows where things stand for the most common modalities.
→ Scroll right to see all columns
| Therapy | Typical coverage status | Common restrictions | Out-of-pocket cost range |
|---|---|---|---|
| Chiropractic | Almost universally covered | Visit caps per year; spinal manipulation only | $30–$100 per session |
| Acupuncture | Covered by ~⅓ of commercial plans | Often limited to pain management conditions | $50–$150 per session |
| Massage therapy | Rarely covered; some Medicare Advantage plans add limited allowances | Condition-specific (e.g. fibromyalgia); visit caps | $60–$120 per session |
| Naturopathy | Seldom covered; initial visit rarely reimbursed | Varies by state licensing laws | $250–$600 initial; $100–$200 follow-up |
| Herbal medicine | Almost never covered | Insufficient clinical evidence for insurers | $20–$80 per consultation |
| Biofeedback / nutritional therapy | Covered if ordered by a medical doctor | Must be part of a documented treatment plan | $75–$200 per session |
Research on CAM users also tells us something important: people who regularly access alternative therapies tend to have lower overall healthcare costs in terms of office visits, prescription spending, and emergency room use. Insurers are beginning to notice, which is why some large carriers now offer discounts for yoga classes or nutrition counselling as a preventive strategy. The financial logic is straightforward — a £50 acupuncture session is cheaper than a £40,000 back surgery — but coverage change moves slowly.
Three traps that leave you paying the full bill
Most people don’t lose coverage for alternative therapies because their plan excludes them outright. They lose it because they miss the conditions attached to coverage. These three mistakes cost patients the most.
Assuming any licensed provider qualifies
Insurers don’t accept every licence. A naturopath licensed in one state may not meet the criteria of your plan, even if their qualifications are identical. Policy language often requires the provider to hold a specific credential — for example, a registered nurse midwife with a master’s degree in midwifery working in a hospital or office with a medical doctor. If your acupuncturist isn’t listed in your insurer’s provider network or doesn’t have the exact licence type specified in your policy, the claim will be denied. Always verify the provider’s credentials against your plan’s requirements before the first appointment, not after.
Skipping pre-approval and documentation
Submitting a claim after treatment is the most common way to get rejected. Many plans require pre-approval — a formal request submitted before care begins, including a treatment plan, progress notes, and a referral from a medical doctor or osteopath. The insurer then assesses whether the therapy meets their criteria for medical necessity, provider qualifications, and scientific evidence. If you start treatment without this step, you’re essentially self-funding. Even with pre-approval, you need itemised invoices that list each service separately. A vague receipt that says “holistic consultation” won’t cut it.
- Check your plan’s provider directory for licensed CAM practitioners
- Obtain a written referral from your GP or specialist before booking
- Submit a pre-approval request with a treatment plan and diagnosis codes
- Use only in-network providers unless your plan specifically covers out-of-network CAM
- Keep itemised receipts with procedure codes for every session
Believing “supplementary insurance” fills all the gaps
Supplementary or rider plans for alternative therapies do exist, but they come with their own limits. The maximum reimbursement for alternative therapies and medicines is often calculated together, meaning a few expensive herbal prescriptions can eat up your entire annual allowance for acupuncture. In the Netherlands, additional coverage for alternative medicine can be bolted onto a basic plan, but the reimbursement cap is typically low. Treat supplementary CAM coverage as a partial offset, not a full safety net. If you rely on regular alternative care, check what the combined therapy-plus-medicine cap actually covers in pounds or dollars, not just in percentage terms.
How to get your alternative therapy covered — from policy check to claim
Coverage exists, but you have to work for it. The process follows a consistent sequence whether you’re in the UK, US, or Australia, though the specific forms and deadlines differ. Here’s what that sequence looks like.
Step one: read the Evidence of Coverage document
This is the single most important document your insurer produces. It lists exactly which alternative therapies are included or excluded, which conditions qualify, any visit caps, and whether pre-approval is needed. Look for the section on “complementary and integrative health” or “outpatient provisions.” If you can’t find it, call the insurer and ask — then get the answer in writing. Some insurers, including Vitality, Aviva, and AXA Health, publish clear CAM coverage levels online. Others bury the details in policy schedules. If you are in the early stages of selecting a plan, it may be worth reviewing your options with a resource like JustAnswer Medicaid & Insurance, which can help clarify what different policies actually include.
Step two: get a referral from a medical doctor
Insurers are far more likely to cover a CAM therapy if it’s recommended by a conventional doctor. A referral from your GP or specialist frames the treatment as medically necessary rather than elective. This is especially important for acupuncture, biofeedback, and nutritional therapy — modalities that research shows are covered more often when ordered by a medical professional. The referral should state the specific diagnosis, why conventional treatment has been insufficient or is not appropriate, and how the CAM therapy addresses the condition.
Step three: submit a pre-approval request
Before your first session, send your insurer a pre-approval package that includes:
– The treatment plan (type of therapy, frequency, expected duration)
– Progress notes from previous consultations (if any)
– The doctor’s referral
– The provider’s licence information
Some insurers now offer telemedicine consultations with naturopathic doctors alongside traditional physicians, which can streamline the approval process. The decision typically comes back within a few weeks. If approved, you’ll know exactly what’s covered and up to what limit. If denied, you have grounds for an appeal — but you must have the documentation ready.
Step four: track every session and payment
Once treatment begins, keep a running log of each session with the date, service provided, diagnosis code, and cost. Submit claims promptly with itemised invoices. If your plan has a yearly visit cap — common for chiropractic (e.g. 12–20 visits per year) and acupuncture — monitor your count so you don’t accidentally exceed it mid-year. An overage may not be covered even if you still have deductible room.
Future changes that could expand coverage
The World Health Organization’s global traditional medicine strategy for 2025–2034 is pushing for greater integration of these therapies into national health systems. In the U.S., patient demand from millennials and Gen Z is driving insurers to add holistic benefits to stay competitive. A few large carriers now include limited allowances for massage therapy and acupuncture in their standard plans, and the trend is accelerating. But coverage remains inconsistent by state and insurer. Some U.S. states mandate coverage for certain alternative therapies; others leave it entirely to insurer discretion. Always check the rules for your specific location and plan before assuming anything has changed. Each approved alternative care claim also sets a precedent that can make it easier for the next patient to obtain coverage, so filing correctly matters beyond just your own reimbursement.
Frequently asked questions about alternative therapy coverage
Does Medicare cover acupuncture for anything other than back pain? ▾
Can I get reimbursed for massage therapy if my doctor prescribes it? ▾
What happens if my alternative therapy claim is denied? ▾
Does the Affordable Care Act require insurers to cover alternative therapies? ▾
Are AYUSH treatments covered under health insurance in India? ▾
If I have a Medigap plan, will it cover alternative therapies that Original Medicare doesn’t? ▾
The bottom line on alternative therapy coverage
The gap between what patients want and what insurers pay for is narrowing, but slowly and unevenly. Chiropractic care is broadly accessible, acupuncture is gaining ground, and most other therapies remain out-of-pocket expenses for the majority of people. The most practical move you can make today is to read your plan’s Evidence of Coverage document before you book a session, not after. If the therapy is excluded, treat it as a budgeted wellness cost rather than a surprise bill. If it’s conditionally covered, follow the pre-approval and documentation steps to the letter.
Remember: this article is general information only. For advice on your specific situation, speak to a qualified professional.
If this was useful, you might also want to read is group health insurance really worth it? examining the pros and cons.
Sources and Further Reading
Why Aussies are switching health funds and how you can too — Practical breakdown of how to compare plans and what Australians look for when changing health insurers, including coverage for extras like alternative therapies.
EBSCO Research Starters (2024). Insurance coverage for complementary or alternative medicine. 🔗
Insurance Informant (2025). Does health insurance cover alternative therapies? 🔗
Insurance Digest (2025). The impact of alternative medicine on health insurance coverage. 🔗
National Center for Complementary and Integrative Health (2023). Paying for complementary and integrative health approaches. U.S. Department of Health and Human Services. 🔗
FAIR Health Consumer (2023). Getting covered for alternative medicine. 🔗
