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Health Care Reform:

Health Insurance & Affordable Care Act

How Health Care Reform Affects Your Pain Treatment

If you have chronic pain, the Affordable Care Act requires your health plan to offer certain services and benefits that can help you. For instance, you will find it easier to get pain medicine. You will also have better access to pain counseling through your family doctor.

But some questions remain. Whether you will be able to use some treatments for pain is still up in the air. Your insurance may not have to cover acupuncture or chiropractic care, for examples. This may depend on where you live. It also is not yet clear just how pain clinics will fit into new health care groups.

Pain Management Benefits

If you bought a health plan through your state’s Marketplace, on the individual market, or have insurance through your small employer, your health plan must cover a core package of benefits under the Affordable Care Act called essential health benefits. You may still have to meet your deductible first and pay a portion of the cost, except for some preventive services. While health plans offered by large employers are not required to include these essential health benefits, almost all do. The pain management benefits include:

If you have Medicare, your plan includes the essential health benefits. So does Medicaid if you now qualify due to your state's expanding of Medicaid.

Pain Treatment and Counseling

Most of your pain management care should come from your family doctor.  There are also specialists in pain clinics that focus on people with more complex cases.  Check with your insurance company or employer to see if these specialists are included in your plan.

Depression and Mental Health Treatment

You might feel depressed or anxious because of your chronic pain. You can get free screening for depression under the new law. You also can get mental health treatment for depression, anxiety, and other mental health conditions.

Alternative Medicine

You might be able to have acupuncture or see a chiropractor for your pain. This depends on where you live and the specifics of your plan. That's because states can choose whether to include these services as part of the essential health benefits package.

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