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Providing the Alternative

Complementary Coverage?

continued...

In announcing the program, BCBSNC's chief medical officer, Robert Harris, MD, said that Alt Med Blue gives members a choice of services that "promote good health."

As alternative medicine practitioners come up with more "hard science" to back up their claims of effectiveness, insurance carriers will be more likely to add coverage for these therapies, says Anna Silberman, president and CEO of Lifestyle Advantage in Pittsburgh.

Lifestyle Advantage, a subsidiary company of Highmark Blue Cross Blue Shield, believes so much in one alternative/complementary medical model -- Dr. Dean Ornish's Program for Reversing Heart Disease -- that it completely pays for its costs. For 10 hours a week patients take part in such activities as moderate aerobic and strength training, yoga, meditation, guided imagery, and visualization, in addition to following a low-fat diet with additional supplements such as fish oil and soy.

"I call this the trifecta," says Silberman. "A program such as this benefits patients, health plans, and providers. I've never come across an intervention that benefits all three entities."

Because of the success of the Ornish program, Highmark is now beginning an Osteoporosis Prevention and Education program, and before the end of the year, Dr. Ornish's prostate cancer prevention program.

BCBSSC, BCBSNC, and Highmark BCBS are just three of the carriers nationwide who have been promoting CAM therapies to their patients. There are certainly more, but according to Eric Wurzel, not enough. Wurzel, a partner in Travers, O'Keefe, a New-York based insurance and employee benefits-based brokerage firm, says that coverage for complementary and alternative medical treatments hasn't grown to the extent that it should. "Eastern medicine has been around longer than western medicine," he says.

Coverage also varies widely from state to state, says Wurzel. New York, for example, is "at least 30 years behind California," he says, adding that benefits for alternative therapies get substantially better the farther south you move. "Costs are prohibitive in New York," he explains. "Anything you add on to a policy here will get used by a large number of people, and those costs aren't cheap."

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