Q. Are diet prescriptions from a Traditional Korean Medicine (TKM) clinic covered by private health insurance? I'm curious about how the process works.

Determining insurance coverage can be complex because each insurance company applies different criteria. Most 'beauty-focused' weight loss treatments are excluded, but those categorized as 'medical treatment' for obesity-related conditions may be eligible. At our clinic, the process typically follows these steps: 1. Constitution and Status Diagnosis: We assess the accumulation of 'Dam-eum' (痰飮), which refers to metabolic waste and fluids that have stagnated in the body, to understand why weight loss is stalled. 2. Root Cause Analysis: We determine if the cause is 'Bi-heo' (脾虛), a deficiency in the digestive system and energy, or the presence of 'Eo-hyeol' (瘀血), which is stagnant blood impeding circulation. The prescription differs entirely based on these findings. 3. Customized Prescription: We prescribe herbal medicine designed to boost metabolism and expel unnecessary fluids and toxins. At this stage, we check if a specific disease code for therapeutic purposes can be applied. 4. Insurance Verification: You can then take your medical receipt and detailed statement to your insurance provider to verify if the claim is accepted for 'therapeutic purposes.' While simple weight loss for aesthetic reasons is rarely covered, treatment for metabolic syndrome or inflammatory conditions associated with obesity may be reviewed. We will work with you to find the most effective clinical path toward your health goals.