HEALTH INSURANCE AND NATUROPATHIC MEDICINE
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Insurance FAQ: Health Insurance Coverage for Naturopathic Care
Navigating health insurance coverage for naturopathic and functional medicine can feel overwhelming. At Body Blu, we believe patients deserve clarity when it comes to understanding their insurance benefits, reimbursement options, and payment choices.
This Insurance FAQ explains how out-of-network reimbursement, superbills, and FSA/HSA medical expenses work so you can make informed decisions about your care.
More and more people in the US wish to use more natural healing methods and are seeking out alternatives to conventional medicine. Naturopathic medicine is one of the fastest growing and most beneficial alternative due to its integrative approach to health care.
Does Health Insurance Cover Naturopathic Doctors?
Insurance coverage for a naturopathic doctor (ND) depends on your specific insurance plan and state regulations.
Some insurance companies recognize licensed naturopathic doctors as eligible providers, while others do not. In many cases:
PPO plans may offer out-of-network benefits
HMO plans typically require in-network providers
Coverage varies by state and policy
We recommend calling your insurance company directly and asking:
Do I have out-of-network benefits?
Are licensed naturopathic doctors covered?
What is my deductible?
What percentage of reimbursement do I receive?
Do I need preauthorization?
Understanding these details upfront helps you avoid surprises and plan your care confidently.
Many people think that naturopathic medicine is not covered by their insurance. This is not always true, many insurance companies do cover naturopathic medicine. Those companies may say that they do not, but it’s often times because they do not know how to handle the claims or may be unaware of the naturopathic medical profession. Below you will find answers to help navigate the insurance industry and help you get the most out of your insurance.
According to the Institute for Natural Medicine, which monitors licensure and reimbursement policies, some states and insurance plans recognize licensed naturopathic doctors and may offer coverage or out-of-network benefits when services meet medical necessity criteria.
What Is Out-of-Network Reimbursement?
If your provider is not contracted with your insurance company, you may still qualify for out-of-network reimbursement.
Here’s how it works:
You pay for your appointment at the time of service.
We provide you with a superbill for insurance reimbursement.
You submit the superbill to your insurance company.
If eligible, your insurance reimburses you directly.
Reimbursement rates vary. Many PPO plans reimburse between 50%–80% after your deductible has been met.
Because every plan is different, we encourage patients to verify benefits before their visit.
What Is a Superbill?
A superbill is a detailed receipt that includes:
Provider credentials
Diagnosis codes (ICD-10)
Procedure codes (CPT codes)
Date of service
Itemized charges
Insurance companies use this documentation to process insurance claim reimbursement.
Submitting a superbill is often the simplest way to access out-of-network benefits. Most insurance companies allow electronic uploads through their member portal.
How Do I Submit an Insurance Claim for Reimbursement?
Submitting a claim is usually straightforward:
Log into your insurance member portal.
Select “Submit a Claim.”
Upload your superbill.
Confirm your mailing address for reimbursement.
Track claim status online.
Some insurance carriers may require a claim form in addition to the superbill. If so, you can download it directly from your insurer’s website.
Reimbursement timelines typically range from 2–6 weeks.
Can I Use My HSA or FSA for Naturopathic Care?
Yes. In most cases, you can use your:
Health Savings Account (HSA)
Flexible Spending Account (FSA)
to pay for qualified medical expenses, including naturopathic visits, lab testing, and certain supplements when medically necessary.
HSA and FSA funds are pre-tax dollars, making this an excellent way to reduce your overall healthcare costs.
If you are unsure whether a specific service qualifies, contact your plan administrator for confirmation.
Often, a letter of medical necessity is required for patients to access their FSA/HSA funds. If you need such a letter, please let us know.
What If My Insurance Denies My Claim?
Insurance denials happen — but they are not always final.
If your claim is denied:
Review the explanation of benefits (EOB).
Confirm that diagnosis and CPT codes were processed correctly.
Contact your insurance provider for clarification.
Ask about the insurance appeal process.
Many patients successfully receive reimbursement after submitting a formal appeal. Insurance companies are required to provide instructions for appealing denied claims.
Persistence often pays off.
What If My Insurance Policy Specifically Excludes Naturopathic Medicine?
If your policy does not cover naturopathic medical services, you can try to modify your policy. Most insurance companies will write a plan to cover naturopathic medicine, but you must request the coverage, depending on if your plan is an individual plan or a group plan.
Individual Plan
Ask your agent to add coverage for naturopathic services. There may be a small charge for this service ranging from nothing to a few cents a month.
Group Plan
Most insurance companies do not charge anything extra to cover naturopathic services on a group plan. Tell this to your employer, union, or human resources director, and ask that naturopathic medicine be added to your plan. If necessary, organize and educate your coworkers on the value and benefit if naturopathic medicine.
Do You Accept Insurance Directly?
At Body Blu, we operate as an out-of-network provider for most insurance plans. This allows us to:
Spend more time with patients
Provide comprehensive, root-cause care
Avoid insurance-driven treatment limitations
Offer individualized treatment plans
While we do not bill insurance directly in most cases, we provide detailed documentation to support reimbursement.
This model ensures higher quality, personalized care.
How Can I Verify My Insurance Benefits?
Before your appointment, we recommend contacting your insurance company and asking:
Are naturopathic doctors covered under my plan?
Do I have out-of-network benefits?
What is my deductible?
What percentage is reimbursed?
Is there a limit on visits per year?
Document the representative’s name and reference number for your records.
Being proactive empowers you to maximize your benefits.
Why Doesn’t Insurance Always Cover Naturopathic Medicine?
Insurance companies determine coverage based on:
State licensing laws
Employer plan design
Medical policy guidelines
Network contracts
Even when coverage is limited, many patients choose naturopathic care because it focuses on:
Root-cause medicine
More time spent with the doctor
Preventative care
Personalized treatment plans
For many, the long-term health benefits outweigh short-term reimbursement limitations.
Tips to Maximize Insurance Reimbursement
To improve your chances of reimbursement:
Verify benefits before scheduling
Meet your deductible when possible
Submit claims promptly
Keep copies of all documentation
Follow up if processing exceeds 30 days
Appeal denied claims when appropriate
Organization and follow-through make a significant difference.
Do Employer-Based Wellness Programs Cover Naturopathic Medicine?
More and more companies are creating wellness programs for their employees as an additional benefit. The more that employers hear from their employees about including naturopathic doctors in health plans, the better!
You can ask your Human Resource Departments about ND inclusion in new or existing Wellness Programs. We can give you a sample letter to customize and forward to your HR representative.
Still Have Questions About Insurance Coverage?
Understanding health insurance coverage for naturopathic medicine can be confusing — but you don’t have to navigate it alone.
Our team is happy to provide the documentation you need for reimbursement and guide you through the process. While we cannot guarantee coverage, we aim to make the insurance experience as smooth as possible.
If you are ready to move forward with personalized care, contact our office today to schedule your appointment.
Where would you like to book your appointment?
Meet Our Medical Team
Our Professional And Highly Trained Doctors
Meet Jordan Scott, ND
You will find Dr. Scott at the Mission Valley and Little Italy locations. Her experience is varied ranging from treating patients with cardiovascular disease, recovery from drug and alcohol abuse, hormone imbalance, weight loss, and musculoskeletal pain, among other primary care conditions.
Meet Joseph Scarpuzzi, ND
You will find Dr. Scarpuzzi at the Cardiff and Temecula locations. He provides natural therapies for men and women looking for hormone treatments, gut health, natural aesthetic procedures, and nutritional therapies. He’s dedicated to finding the root cause and helping his patients achieve optimal health.
Results may very person to person. Services, prices + availability are subject to change without prior notice. Please call ahead for verification. Body Blu does not bill insurance. We accept cash + credit cards only. We do not accept personal checks. Patients, please contact your insurance carrier to pre-authorize use of FSA + HSA cards for allowable treatments. Payment is due before or upon receipt of services. We do not offer refunds for services, treatments + pre-paid packages. Please review our Practice Policies for detailed information.