Paying for CAM Treatment 

Many people using or thinking about using complementary and 

alternative medicine (CAM) treatments may have questions about 

paying for treatment. This fact sheet provides a general overview of 

related topics and suggests sources for additional information. 

CAM Spending in the United States 

According to the 2007 National Health Interview Survey (NHIS), 

adults in the United States spent an estimated $33.9 billion out-ofpocket on CAM treatments during the past 12 months. Of the 

$33.9 billion, adults spent an estimated $22.0 billion on self-care 

costs (i.e., CAM products, classes, and materials), while they 

spent the remaining $11.9 billion on visits to CAM practitioners. 

Out-of-pocket expenditures on CAM treatments accounted for 

approximately 1.5 percent of total health care expenditures and 

11.2 percent of the total out-of-pocket health care expenditures in 

the United States. 

Paying for CAM Out of Pocket 

People usually pay for CAM services and products themselves, i.e., 

“out of pocket.” Even if they have health insurance (the 2007 NHIS 

found that about one-third of uninsured respondents younger than 

age 65 used CAM), there is a good chance that their plan does not 

cover most, or any, CAM therapies. 

Asking CAM Practitioners About Payment 

If you are planning to use a CAM service, it is important to 

understand about payment before you begin treatment. Here are 

some questions to ask the practitioner: 

 Costs: What does the first appointment cost? What do follow-up 

appointments cost? How many appointments am I likely to 

need? Are there any additional costs (e.g., tests, equipment, 

supplements)? 

 Insurance (if you have a health insurance plan): Do you accept 

my insurance plan? What has been your experience with my 
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 plan’s coverage for people with my condition? Do I file the claims, or do you take care of 

that? 

 Payment options (if it would be difficult for you to pay the full fee for each visit): Could you 

arrange a payment plan over time? Do you offer a sliding-scale fee (i.e., fees based on 

income and ability to pay)? 

Private Insurance and CAM 

Private health insurance plans may offer coverage of certain CAM therapies, such as 

chiropractic, acupuncture, and massage. Overall, however, coverage of CAM therapies is 

relatively limited—compared with coverage of conventional therapies. One factor is a lack of 

scientific evidence regarding the cost-effectiveness of CAM therapies. As consumer interest in 

CAM grows, more insurance companies and managed care organizations may consider 

offering coverage of CAM therapies shown to be safe and effective. 

About Employer-Sponsored Health Plans 

Many people with private health insurance are covered by employer-sponsored plans. While 

these employer-sponsored plans are more likely than others to offer CAM coverage, the benefit 

is likely to cover only certain CAM therapies, and other restrictions may apply: 

 Deductibles and/or copayments may be higher than those for conventional care. 

 You may need preauthorization or a referral from your primary care physician. 

 You may be limited to an approved network of providers. 

 There may be ceilings on the number of visits or the annual dollar amount paid. 

Some employers offer CAM coverage by allowing employees to purchase CAM “riders” to their 

standard health insurance plans. Some offer discount programs, in which plan members pay 

for CAM services out-of-pocket but at a discounted rate the insurer has negotiated with 

participating providers. 

General information on employer health plans and benefits is available from the 

U.S. Department of Labor at www.dol.gov/dol/topic/health-plans/index.htm. 

Understanding Your Insurance Plan’s Coverage of CAM 

It is important to read your plan to find out whether it discusses coverage of the CAM therapy 

in which you are interested. If you have questions, contact the insurance company before you 

decide about having treatment. Examples of questions to ask include: 

 Is this treatment covered for my health condition? 

 Does this treatment need to be 

o Preauthorized or preapproved? 

o Ordered by a prescription? 

 Do I need a referral from my primary care provider? 

 Do I have to see a practitioner in your network in order to be covered? 

 Do I have any coverage if I go out-of-network? 
 Are there any limits and requirements—for example, on the number of visits or the 

amount you will pay? 

 How much do I have to pay out-of-pocket? 

Keeping records about all contacts you have with the insurance company, including notes on 

calls and copies of bills, claims, and letters, is a good idea. This will help you if a dispute arises 

about a claim. 

Sources of Information on Insurers 

Your state insurance department may be able to help you determine which insurance 

companies cover CAM. Contact information for these departments is available at 

www.consumeraction.gov/insurance.shtml. 

Professional associations for CAM specialties may monitor insurance coverage and 

reimbursement in their field. You can search for them on the Internet or ask a reference 

librarian for help. 

Tax-Related Matters 

Two kinds of tax-exempt accounts help people save money for health expenses, and may help 

you cover CAM costs. The flexible spending account is a benefit offered by some employers; it 

allows you to set aside pretax dollars each pay period for health-related expenses. The health 

savings account is for people who participate in high-deductible health plans (also called 

catastrophic health plans); you, not an employer, establish this kind of account. For more 

information, see Internal Revenue Service (IRS) Publication 969, Health Savings Accounts and 

Other Tax-Favored Health Plans (www.irs.gov/pub/irs-pdf/p969.pdf). 

Some CAM expenses may be tax deductible. In tax year 2009, the IRS allowed taxpayers to 

deduct medical expenses for acupuncture, chiropractic care, and osteopathic care. For more 

information, see IRS Publication 502, Medical and Dental Expenses (www.irs.gov/pub/irspdf/p502.pdf). 

Federal Health Benefit Programs 

The Federal Government helps with at least some of the health expenses of people who are 

eligible for Federal health benefit programs, such as programs for veterans, people age 65 

and older (Medicare), and people who cannot afford health care (Medicaid, funded jointly 

with the states). 

Information on health benefits for veterans is available from the U.S. Department of Veterans 

Affairs at www1.va.gov/health/. Information on Medicare and Medicaid is available from the 

Centers for Medicare and Medicaid Services at www.cms.hhs.gov/. Two other Internet 

resources—GovBenefits (www.govbenefits.gov) and USA.gov (www.usa.gov)—explain Federal 

health benefit programs. GovBenefits has a test you can take about qualifying for programs. 
NCCAM’s Role 

The National Center for Complementary and Alternative Medicine (NCCAM) helps to build the 

evidence base used to make decisions about whether CAM treatments are safe and effective. 

Financial help for CAM treatment is not part of NCCAM’s mission. NCCAM does sponsor 

clinical trials (research studies in people) of some CAM treatments. To find out what therapies 

are being studied and whether you might qualify to participate, go to nccam.nih.gov/research/ 

clinicaltrials or contact the NCCAM Clearinghouse (see “For More Information”). 

For More Information 

NCCAM Clearinghouse 

The NCCAM Clearinghouse provides information on CAM and NCCAM, including publications 

and searches of Federal databases of scientific and medical literature. The Clearinghouse does 

not provide medical advice, treatment recommendations, or referrals to practitioners. 

Toll-free in the U.S.: 1-888-644-6226 

TTY (for deaf and hard-of-hearing callers): 1-866-464-3615 

Web site: nccam.nih.gov 

E-mail: info@nccam.nih.gov 

PubMed®

A service of the National Library of Medicine (NLM), PubMed contains publication information 

and (in most cases) brief summaries of articles from scientific and medical journals. CAM on 

PubMed®, developed jointly by NCCAM and NLM, is a subset of the PubMed system and focuses 

on the topic of CAM. 

Web site: www.ncbi.nlm.nih.gov/sites/entrez 

CAM on PubMed®: nccam.nih.gov/research/camonpubmed 

Agency for Healthcare Research and Quality (AHRQ) 

AHRQ conducts research on health care outcomes, quality, costs, use, and access. It also has 

consumer information on health insurance and other topics, including the publication 

Questions and Answers About Health Insurance: A Consumer Guide. 

For public inquiries: 1-301-427-1364 

Web site: www.ahrq.gov 

Consumer insurance information: www.ahrq.gov/consumer/qualcare.html#plans
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This publication is not copyrighted and is in the public domain. 

Duplication is encouraged. 

NCCAM has provided this material for your information. It is not intended to substitute 

for the medical expertise and advice of your primary health care provider. We encourage 

you to discuss any decisions about treatment or care with your health care provider. The 

mention of any product, service, or therapy is not an endorsement by NCCAM. 

National Institutes of Health 



U.S. Department of Health and Human Services
D331 

Updated May 2010