November 1997
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November 1997 |
The first asks if Human Resources has looked into adding an additional option to the medical plan that would cover alternative medicine. We have not. Group plans covering alternative medicine are not common but do exist. We have not been approached by any provider of alternative medicine plans, and are not aware of any provider in the area. In the past two years, we have had no employee ask for such separate coverage. If there were sufficient employee interest, and if the costs were comparable to our newer medical plans, we would certainly investigate the possibility of adding such an option. Since this would add to our administrative costs, there would need to be significant employee participation to justify the additional option.
The second question is more common and concerns provision of our current plans. UCAR currently offers three basic plans. Two of them, Kaiser and PacificCare EPO, are HMOs, and the provisions of the plans are generally established by the providers. These plans are designed to be cost-efficient and include standard medical preventative care. Both plans have some restrictions on treatments and providers. Adding alternative medicine options to these plans is inconsistent with the intent of the plans and would increase the cost to UCAR and all participants.
The third UCAR plan is the PacifiCare PPO plan. This plan allows employees more flexibility in providers and treatment plans, as long as the treatment is medically necessary. This plan allows for certain treatments by practitioners of acupuncture or chiropractic medicine. Chiropractic care is covered only when medically necessary because of injury or illness incurred under this plan. Maintenance care is not covered.
Acupuncture is covered for the relief of pain. As mentioned in the summary plan description: "Eligible diagnoses include but are not limited to: a) pain from surgical procedures; or b) pain from injuries that involve strains or sprains of muscles, ligaments, or tendons of any body part. Ineligible diagnoses include but are not limited to: a) hepatitis, b) flu, c) allergies, d) weight loss, e) smoking cessation, f) internal pain, or g) other general illness.
Chiropractic and acupuncture treatments are subject to review for medical necessity and may have additional limits on the number of sessions allowed. UCAR relies on PacifiCare to determine medical necessity and eligibility of all claims.
Other alternative medical practices, including naturopathic services, are not covered at this time. There is no plan to add new alternative medical practices to the plan in 1998. While we are not aware of any personal plans that may cover alternative medicine, you may check with local practitioners to see if they know of plans that provide supplemental coverage.
--Bob Roesch, Human Resources manager
| Questions and suggestions from the staff to management may be submitted in confidence to the Delphi coordinator, Rene Munoz (ext. 1173, ML room 135), in written form; they must be signed. Detailed procedures for submitting questions are given in the UCAR Policies and Procedures Manual, section 1-1-13. Questions and answers of general interest to staff are submitted to Staff Notes Monthly by Rene. They may be edited for publication. For more information, see the Delphi Service Web page. |