Insurance Coverage for Nutrition Counseling
Verify Coverage
Your nutrition counseling appointments may be covered if you are a member of Blue Cross Blue Shield, Medica, United Healthcare, or Medicare.
It is your responsibility to contact a member services representative to verify coverage. The phone number is on the back of your card. To help, we've put together some important questions to ask your member services representative.
Blue Cross Blue Shield, Medica, and United Healthcare Members
For a printer-friendly PDF of those questions, click here for The Insurance Handout – Commercial.
Medicare, Medicare Supplement or Medicare Replacement plans
For a printer-friendly PDF of those questions, click here for The Insurance Handout – Medicare.
Please contact Pamela@weightandwellness.com with any additional questions.
FAQs about insurance coverage
Q: What are your in-network insurances? Answer
We are providers of Blue Cross Blue Shield, Medica, United Healthcare, and Medicare. We only send claims to these insurance companies. Polices within these companies vary. Not all policies cover nutrition counseling.
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Q: Do you accept insurance other than Blue Cross Blue Shield, Medica, United Healthcare, and Medicare? Answer
No, currently we are only contracted with Blue Cross Blue Shield, Medica, United Healthcare and Medicare. If you want to submit a claim to your insurance we can provide you with the necessary information. Please let us know at the time of booking your appointment so we can have the paperwork ready for you to take with you to submit to your insurance company. You will need to pay for your appointment at the time of service.
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Q: What is the cost of nutrition counseling? Answer
The insurance rate for an initial consultation (1 1/2-hours) is $300 and a follow-up consultation (1-hour) is $160.
We can give a discounted rate for private pay clients, those who pay out-of-pocket at the time of service. The private pay rate for an initial consultation (1 1/2-hours) is $250 and a follow-up consultation (1-hour) is $120. It is important to know if you want to send a claim into insurance or private pay before your appointment. If we submit a claim for nutrition counseling and your claim is denied, you will be required to pay the full insurance rate
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Q: Will Medicare, a Medicare replacement plan, or a Medicare supplement plan cover nutritional counseling? Answer
These plans have very limited coverage and will only cover for a diagnosis of diabetes (not prediabetes); chronic kidney disease stage 1, 2, or 3; or if you have had a kidney transplant in the last 36 months. Also, the time is limited, those plans will only cover 3 hours per year the first time you see a nutritionist and 2 hours per year for subsequent years. The Medicare replacement plan must be from Blue Cross Blue Shield, Medica, or United Healthcare in order for us to submit a claim. You will need to obtain a doctor’s order each year.
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Q: Will my Blue Cross Blue Shield , Medica or United Healthcare insurance policy cover nutritional counseling? Answer
There are many different plans, and we cannot guarantee that your policy will cover nutrition counseling. It is your responsibility to call the member services number on the back of your card to verify your coverage before you schedule your appointment. If we submit a claim for nutrition counseling and your claim is denied, you will be required to pay the full insurance rate.
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Q: What if I have more than one insurance policy? Answer
We can only submit claims to Blue Cross Blue Shield, Medica, United Healthcare or Medicare. One of those policies needs to be your primary insurance for us to submit a claim. If you are unsure which insurance is primary, please call a service representative of either insurance and ask.
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Q: What if my insurance doesn’t cover nutrition counseling or denies coverage once a claim is submitted? Answer
The insurance rate for an initial consultation (1 1/2-hours) is $300 and a follow-up consultation (1-hour) is $160.
We can give a discounted rate for private pay clients, those who pay out-of-pocket at the time of service. The private pay rate for an initial consultation (1 1/2-hours) is $250 and a follow-up consultation (1-hour) is $120. It is important to know if you want to send a claim into insurance or private pay before your appointment. If we submit a claim for nutrition counseling and your claim is denied, you will be required to pay the full insurance rate
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Q: Will I have a co-pay for a nutrition counseling appointment? Answer
You may, you will need to ask your member service representative. We do not collect co-pays, co-insurance or deductibles at the time of your appointment. If you have a co-pay, co-insurance or a deductible, you will be billed.
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Q: Will I need a referral from my doctor? Answer
That depends on the plan. Because there are many different plans, it is your responsibility to call the member services number on the back of your card to verify your coverage for nutrition counseling and find out whether you will need a referral from your doctor before you schedule your appointment. Medicare always requires a doctor’s order.
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Q: How many times can I see a nutritionist? Answer
That depends on the plan. Because there are many different plans, it is your responsibility to call the member services number on the back of your card to verify your coverage for nutrition counseling and to see if there is a limit to the number of nutrition counseling sessions allowed.
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Q: Can I use my HSA or FSA account to pay for products and services at Nutritional Weight & Wellness? Answer
We cannot guarantee our products and services are allowable under your HSA or FSA account. Contact your HSA or FSA account manager for more information.
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Q: Does insurance cover nutrition classes? Answer
For more information about virtual or in-person nutrition counseling, refer to our main counseling page.
Still have questions?
Give us a call at 651-699-3438, use the chat in the bottom right, or fill out the form below.
