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 159percentage 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.

Short list of insurance Companies who may offer reimbursement:

  • 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. Pathnostics-PGx testing is usually covered.

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 Arizona, so aren’t they covered on my policy?
  • 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 Desert Naturopathic Health if you have more questions at 602-888-1201.