(MONEY Magazine) – Like many journalists, I've long suffered from carpal tunnel syndrome, a typing-related repetitive stress injury. Last year, though, physical therapy stopped doing me any good. When my doctor mentioned surgery, I started asking around about alternative therapies like acupuncture. (I was afraid of needles, but even more afraid of a surgeon's knife.) A certified acupuncturist brought relief to my arms but pain to my wallet: Ten visits cost me $600, which my health insurer would not reimburse. More frustrating still, I learned that my miracle worker was on the provider list for Prudential (now a division of Aetna), a health insurance option offered by my company. Had I chosen that plan, I'd have saved $450.

Two out of three Americans now use acupuncture, herbal medicine, chiropractic and other complementary and alternative medicine (CAM), according to a 1998 survey by American Specialty Health (the nation's largest alternative managed-care company) and the Stanford University School of Medicine. And they pay dearly: Americans spent $27 billion out of pocket for CAM treatments, reported a 1998 study by Dr. David Eisenberg of Harvard Medical School. Respondents in the American Specialty Health/Stanford study reported paying, on average, $270 a year for acupuncture, $157 for chiropractic and $111 for herbal medicine.

Today 42 states require private insurers to cover chiropractic treatments, and two states (Washington and Wisconsin) require insurers to offer coverage at an extra charge; six states mandate acupuncture coverage, and California requires insurers to offer an acupuncture rider; two states require massage coverage, and four naturopathy (herbal and natural medicine). Medicare covers chiropractic treatment under certain circumstances. And now employers--under pressure to please workers in today's tight labor market--are including CAM in the plans they offer their employees. From 1990 to 1997 the percentage of employer-provided health plans that covered some alternative therapies rose from 30% to 70%. Two-thirds of HMOs now offer CAM, most often chiropractic (65%) or acupuncture (31%), according to Landmark Healthcare of Sacramento.

For now, though, most elements of alternative health-care coverage are considered a premium add-on. "The more [coverage] you add to a benefits package, the more it's going to cost," says Mohit Ghose, a spokesman for the American Association of Health Plans. Dr. Robert A. Schulman of the board of directors of the American Academy of Medical Acupuncture notes, "In my patient population in Manhattan, it's the people with high-caliber jobs, or those who work at large corporations or progressive companies like dotcoms, who have coverage."

Even if you aren't a dotcom employee with the fanciest insurance, you may be able to get some help with your alternative health-care costs. Here are some tips.

Factor alternative care into your choice of insurer

If you think you will use a significant amount of alternative medicine over the coming year, shop accordingly during November's open-enrollment season. The right choice now could give you access to treatments that might otherwise be prohibitively expensive. Start by consulting our table of major insurers (below)--but be sure to double-check specifics with your employer's benefits administrator, since details vary from company to company and from state to state.

Also, plan administration tends to be labyrinthine, so document your conversations. If a benefits administrator tells you that a therapy is covered, note the date, the name of the person who gave you the information and, if possible, get written confirmation for your files.

Get your doc to prescribe treatment

Sometimes, a doctor's referral makes all the difference. Take Zelda Harris, a teacher in Seattle, for example. She went to a massage therapist for chronic back pain; her Blue Cross policy covered 50% of the cost. But by obtaining a prescription from her doctor, Harris was able to raise her coverage to 90%. "Basically, I get these massages for $4.80," she says.

In the prescription, Harris' doctor, Dr. Leslie Althouse, included her diagnosis, previous treatments that were unsuccessful and her opinion that massage therapy was appropriate. "From the provider's perspective, if you push hard enough, you can usually get things to go through," she says.

Of course, this tactic presumes that you've told your doctor about your alternative therapies, which is a good practice in general. Your doctor may be skeptical, but there's no benefit, and even some risk, to keeping mum. "People need to tell their primary-care doctors that they're taking herbs, for instance, because certain ones could interact with other prescriptions they may be taking," says Steve Gorman, president of the International Union for the Natural Health, Complementary and Alternative Medicine Professions, a labor organization that promotes CAM therapies.

Make use of discounts

Many insurers that don't usually cover alternative therapies, including Aetna U.S. Healthcare and UnitedHealthcare, do offer discount programs. Essentially, alternative-care providers agree to knock 20% or more off their prices in exchange for membership in the plan network. (Just as it is with doctors, though, if your favorite practitioner is not in the network, you're out of luck.) Since a discount is not a covered benefit, you don't need a doctor's referral or any other paperwork. "The discount programs are a start. Once health plans implement a discount program, there is often interest from employers in getting more," says George DeVries, CEO of American Specialty Health.

Use your flexible spending account

If your company offers a medical spending account, you can apply it to alternative care--so long as your choices qualify. "Acupuncture and chiropractic care are specifically mentioned as acceptable treatments," says Don Roberts, a spokesman for the Internal Revenue Service. "Homeopathy and naturopathy are not." Treatments must be related to a specific, diagnosed ailment to be considered a qualifying expense; feel-good massages don't cut it. The IRS does not usually allow claims for over-the-counter drugs, herbal supplements, vitamins or medical marijuana. For details, check IRS Publication 502, available online at www.irs.gov in the area called Forms and Pubs, or call 800-829-3676.

Lobby your employer for better benefits

Many employers treat benefits as an employee-retention tool. Companies can fund a plan that covers acupuncture and chiropractic care for an employee plus dependents for $5 to $10 per worker per month, says American Specialty Health's DeVries.