Receiving counseling services from a top nutritionist can be a boon to your overall wellness, but there’s also the matter of your financial wellness. So, it only makes sense that you’d find whatever possible way to cut costs.
For instance, you’re probably wondering, “Are nutritionists covered by insurance?” We’ll answer that question below:
What Are the Benefits of Insurance Coverage for Medical Nutrition Therapy?
Let’s do some quick math.
The median income of the average American worker is a touch north of $54,000 per year. That seems reasonable until you realize the cost of living continues to skyrocket—just for the basics. Never mind the ability to afford expert nutritional counseling, which often costs up to $200 per consultation without insurance.
Insurance offers the best of both worlds for people needing nutritional counseling:
- You can optimize your overall health.
- You save money.
It’s a win-win.
Shedding Light on Insurance for Nutritional Services
Here, we’ll answer in detail whether nutritionists are usually covered by insurance.
So, Are Nutritionists Covered by Insurance?
Broadly speaking, nutritionists can indeed be covered by insurance in the US. In fact, according to Today’s Dietitian Magazine, it is widely covered by many insurance plans.
That’s promising to hear for people who need to start seeing a nutritionist and have insurance.
Yet, as many of us who’ve had to rely on our health insurance before will know, coverage can get complicated.
Despite thinking that you should be covered and having no reason to believe otherwise, it’s possible to receive an unfortunate surprise when it’s time to reap the benefits.
The only way to ensure that your insurance covers you if you want to receive nutritional counseling from a Registered Dietitian is by educating yourself. Reading this article is an ideal start.
Getting into the Specifics of Health Insurance and Nutritionists
Per NutritionEd.org, nutrition services are available—under the Affordable Care Act–to all adults who have or are at risk for chronic diseases. This care is provided through nutritional counseling, with zero copayments charged.
This stipulation exists regardless of the health insurance, whether private insurance, Medicaid, or Medicare.
Medicaid and Nutrition Therapy Coverage
Medicaid is typically provided to low-income adults, elderly adults, pregnant women, children, people with disabilities, etc.
Coverage for Medicaid varies from state to state and extends to Medical Nutrition Therapy.
Some states don’t recognize Registered Dietitian-Nutritionists as Medicaid providers. However, nutrition therapy must be recognized by Medicaid as an optional preventative care service. Based on the provision of the Affordable Care Act, the therapy would amount to obesity treatment and prevention.
Note that clients with prediabetes might be covered by the National Diabetes Prevention Program (National DPP), which could include Medical Nutrition Therapy. But it’s only available in certain states.
Medicare and Nutrition Therapy Coverage
Typically, Medicare is for seniors (adults 65 and over), but it can start as early as 62. It is uniform from state to state, as it’s federally operated, and it covers medical nutrition therapy under specific circumstances.
Namely, clients who’ve experienced kidney disease, diabetes, or kidney transplants in the past 36 months can receive Medicare coverage for Medical Nutrition Therapy. They’ll also receive coverage if they’re at risk.
Primary care physicians must refer their patients for Medical Nutrition Therapy for the patient to receive Medicare coverage. A Registered Dietitian or Registered Dietitian Nutritionist can provide this care. Or a nutritional healthcare provider can offer care if they meet Medicare’s rigorous requirements.
Private Insurance and Nutrition Therapy Coverage
Since private health insurance isn’t government-run, there’s a seemingly endless variance in potential coverage for a nutritionist.
If you have fantastic coverage, it could extend to Medical Nutrition Therapy for anything from chronic disease prevention to improved athletic performance. It depends on your plan.
Your plan will likely be subject to any number of stipulations, like how many sessions are covered (e.g., per year or lifetime). Typically, clients must be referred through a primary care physician to receive coverage, but that’s not always the case.
Most often, the client must make a copayment to their nutritionist. Also, most private insurers require that nutritionists be state licensed as Registered Dietitians or Registered Dietitian-Nutritionists through the CDR to provide coverage.
Remember Your Deductible
Health insurance protects you from sky-high medical costs, but that doesn’t mean it makes health care free.
You first have to meet your deductible—the minimum cost for the insurance to kick in.
So, if your plan has a $1,500 deductible, your bill must reach that amount to receive coverage. Even then, most marketplace plans will cover 60% to 90% of the expenses post-deductible. You’re still paying the remaining 10% to 40% on top of the deductible cost.
This is also on top of your out-of-pocket maximum, which you’d have to pay no matter how much covered care you receive. Therefore, it’s wise to take advantage where you can if you have health insurance.
Provided you have chronic health problems or something more severe, the chances are high that you’ll receive coverage for a nutritionist through Medicare, Medicaid, or private health insurance. However, a highly flexible private health insurance plan is likely the only way to receive coverage for broader and less urgent nutritional needs.
Do you have insurance coverage and are interested in receiving Medical Nutrition Therapy? If so, take our quiz, and we will match you with a Registered Dietitian-Nutritionist tailored to your goals and medical needs.