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Does medical insurance cover nutritionist?

Keep in mind...
  • Most insurance covers nutrition counseling if deemed medically necessary
  • Patients with high blood pressure, heart disease, kidney disease, and diabetes can benefit from nutrition therapy
  • Not all patients will qualify for coverage, but they can still pursue a healthier lifestyle with plenty of free resources

The food you consume can be the best form of medicine or your biggest vice. You don’t need a physician or health care professional to tell you that you should probably eat better. Eating healthy foods and being active can lead to a healthier lifestyle. An excellent diet can help control diabetes, issues with blood glucose/sugar, blood pressure, and even cholesterol levels.

Any of the conditions above left unmanaged can lead to serious complications including heart attacks, strokes, kidney failure, nerve damage, blindness, and even amputation. The conditions mentioned above aren’t exhaustive.

Significant health issues could lead your physician to recommend you meet with a nutritionist. Medical nutrition therapy (MNT) and related services may be covered by your health insurance if your situation meets certain requirements. If your condition doesn’t meet the requirements set forth by your insurance company, MNT visits may not be covered. So how do you tell the difference?

Make sure to get free health insurance quotes with your zip code on our site to ensure your plan is the best one you can afford!

What’s included with a medical nutrition therapy?

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If your doctor has recommended medical nutrition therapy, he/she probably believes a change in your diet could enhance your overall health. When you attend these appointments, you can expect to meet with a registered dietician or nutrition professional.

These health care providers will assess your diet and lifestyle during the initial interview. Next one-on-one counseling regarding your diet and lifestyle will begin. Follow-up visits and checks will be scheduled as needed to monitor progress and see how you are managing your new diet.

Some medical conditions require long-term relationships between a patient and nutritionist. These conditions also qualify patients for coverage through most insurance companies including Medicare and include:

  • Dialysis patient
  • Diabetes
  • Kidney disease
  • Post kidney transplant (less than three years)

How to Get a Referral to a Dietician

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If you want to see a nutritionist to help you achieve a healthy lifestyle, you’ll have to talk to your doctor about it; especially if you have Medicare Part B.

Under Part B, patients have access to a nutritionist but need a referral from their primary care or specialist. Many commercial insurance companies align with Medicare requirements regarding when and how these benefits are covered.

Read Between the Lines to Find Out What’s Covered

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When you contact your commercial insurance company to ask about MNT, you’ll have to understand their lingo to get the right answers and ask the most appropriate questions. Most plans refer to dietician visits as medical nutrition therapy. Other commercial carriers refer to these benefits as nutrition counseling.

If you find that these benefits are covered, you must do a bit more research to determine if the services are covered for your condition. Some carriers include the services, but only for subscribers suffering from the following conditions:

  • Kidney failure
  • Hypertension
  • Diabetes
  • Obesity

If your medical insurance only covers nutrition services for the conditions listed above, you’ll need to find out if there are any benefits for preventative nutrition services. Many carriers have a distinct difference between the two different types of coverages.

What’re preventative nutritional services?

At this point, you are probably wondering what preventative nutritional services are and why they are different and handled as so by health insurances.

The primary distinction is those receiving MNT services are already suffering from a significant disease that is affecting their overall health. For these people, a diet and lifestyle makeover is needed to control the disease.

Those in need of preventative nutrition services aren’t suffering the full effects of a disease such as diabetes or hypertension. However, these patients may be suffering from high blood pressure, a family history of heart disease, or elevated lipids.

A patient in the categories mentioned above may need nutritional services to decrease the chance of developing a more severe disease.

Weight Loss and Athlete Nutrition Service Coverage

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Another group of patients that often seek nutritional services included those looking to lose weight and athletes. Under most insurance coverage plans – neither of these patient groups are eligible for insurance coverage nutritional therapy.

Those looking to lose weight want to make changes in their diet to help them make better food choices. It’s important for these individuals to visit with a dietician to keep themselves healthy, but that doesn’t mean they’re automatically covered for nutritional services.

The one factor that may make them eligible for coverage would be whether the weight loss was recommended by a physician to improve their lifestyle or existing health issue. If the answer to this question is no, the patient will likely have to pay out of pocket for nutrition services.

Athletes often use a dietician to help them make great choices for their sport. Whether they need more protein for muscle production or want to drop a few lbs fast, a dietician can help them make these decisions safely. However, since none of these changes are necessary for medical reasons – an athlete will likely need to pay for these services out of pocket.

Dietary Counseling for Mental Health Issues

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Many mental health issues can affect a person’s weight. If a patient has a mental illness – specifically an eating disorder — dietary services will likely be covered. Additionally, if mental health conditions require a patient to be hospitalized, intensive nutritional counseling will also likely be covered by health insurance.

What to Expect at Your First Nutritionist Appointment

 

A nutritionist will want to dive into your medical history. They’ll go over your physician’s concerns and discuss food preparation with you in detail. If you have any cultural food preferences, you’ll need to share those with the dietician. Other topics that will be discussed include eating habits, food choices, and exercise.

The goal will be to analyze food choices and provide meal plans that are unique to lifestyle and goals.

Although it’s impossible to provide a straightforward answer regarding whether you will qualify for nutritional services, the information furnished above should help you determine eligibility.

Explore your nutritionist coverage options by comparing free health insurance quotes with your zip code!

Free Health Insurance Comparison

Compare Quotes from Top Companies and Save

or call (844) 994-1147 for free quotes