Insurance and Naturopathic Medicine
Although licensed naturopathic
physicians (an N.M.D. or N.D.) may not be considered a health care
provider on most health care plans, many insurance companies
consider Naturopathic Physicians as out-of-network providers. A
large percentage of our patients are reimbursed for up to 80% of
office visit fees. Most insurance companies have historically paid
little to nothing for naturopathic medical health care and other
integrative medical services. With the growing trend of integrative
medicine, coupled with the increasing validity and efficacy of
naturopathic medicine, many insurance companies are recognizing
licensed naturopathic physicians and their services with insurance
reimbursement.
What do you mean by insurance reimbursement?
At the time of your visit, you pay
for services rendered (“fee for service”), which may include
laboratory testing. You are provided with a completed form that is
ready to be submitted to your insurance company. After which you
simply mail this form to your insurance company and they send you a
reimbursement check after your deductible is met. As an example,
many of our patients with Cigna Healthcare are reimbursed 80% after
they have met their deductible.
- Aetna
- Cigna
- Blue Cross/Blue Shield
- Lifewise
- Lumenos
- United Healthcare
What about Laboratory services?
Most private indemnity insurance
carriers cover tests including PPO, EPO and POS plans. Patients are
responsible for co-payments and are invoiced for this fee, usually
by the lab that does the testing. Patients who have not met
their deductible may also receive an invoice. HMO’s typically do not
pay for tests, but it is still possible. Specialty labs, such as
Heavy Metal Testing, Food Allergy Testing, Intracellular Nutritional
Testing and others are drawn at our office and are either paid for
as fee for service or with a copay. Our office can work with these
labs to bill your insurance for these specialty labs. In any case,
the best advice is to call and ask your insurance company what
laboratory services are covered, and if there are any restrictions
regarding out of network providers ordering them.
What about herbal and nutritional
supplements?
Vitamins, herbs, homeopathic remedies, natural supplements and tinctures are not currently covered by insurance plans. Fortunately, many natural supplements are very reasonable and their supervised use can prevent health issues requiring expensive pharmaceuticals.
What about Medicare/Medicaid?
Naturopathic Physicians are not
eligible to be providers within the Medicare/Medicaid network. This
has to do mainly with government legislation at this time, and will
change eventually. Unfortunately for now, patients who have
Medicare/Medicaid coverage have no choice but to pay fee for service
in order to receive services provided by Naturopathic Physicians,
and no Medicare/Medicaid reimbursement is available.
What does my Healthcare Insurance Plan Cover?
Please contact your insurance plan
to verify your specific coverage for complementary and alternative
medicine. Ask your insurance company the following questions to
determine what services are covered:
- Are
naturopathic medical services covered on my policy?
- If I go to
a licensed naturopathic physician are they considered an out-of
network provider?
-
Naturopathic physicians are licensed physicians in the state of
- Is
acupuncture, preventative medicine, nutritional counseling, or
any "alternative" forms of medicine covered on my policy as an
out-of-network provider service?
- What is my
deductible? Once this is met if I go out-of my network will I be
covered?
- I would like to request that my naturopathic physician be added to your provider list and/or be considered an out-of network provider.
- Are there other healthcare policies close to my existing policy that would cover naturopathic medical services?
Call DC Canyon Health and Wellness center if you have more questions at 623-215-4107.
Call us if you have more questions!
623-215-4107