Does Health Insurance Cover Naturopathic Medicine?

In Oregon, most commercial health insurance companies offer plans that cover office visits with naturopathic doctors. In many cases, laboratory testing and diagnostic imaging will also be covered when ordered by a licensed naturopathic doctor. Additionally, some OHP medicaid plans and Medicare Advantage also cover naturopathic medicine.

Naturopathic doctors are licensed medical providers in the state of Oregon, so many insurance companies cover naturopathic medical services in the same way they cover a visit with any other type of physician. With that said, health insurance plans vary greatly even within the same insurance company, so it’s important to be familiar with your own health insurance benefits before seeking care. It is your responsibility to find out what services are covered and you will be financially responsible for any balances not reimbursed by your insurance.

How to Check Your Benefits for Naturopathic Medicine

If you’d like to find out if your insurance company will cover naturopathic medical services, here are a few things you can do:

  • Review your policy
    • Sometimes your health plan documents will specifically say if naturopathic medicine is covered.
    • If you have an HMO plan you may be limited to seeing providers who work for that company (for example Kaiser). In most cases these plans will not cover naturopathic medicine.
  • Call your insurance company
    • To check your insurance benefits, call the customer service number on the back of your insurance card. Ask for benefits/eligibility. Tell the phone representative you’re calling to check on your personal insurance benefits.
    • Here are the questions you want to ask:
      • Does my policy cover services that are performed by a licensed naturopathic doctor?
        • If they are unsure, you can ask if your policy specifically excludes naturopaths as covered providers in its definition of physician.
      • Is there is a deductible I need to meet in regards to this service?
      • How much of my deductible do I still have to meet this year?
        • This is the amount you will pay out of pocket this year before services are covered. The amount is renewed each year.
      • Is Dr. Cori Burke is in-network with my plan?
      • What is my co-pay or co-insurance?
      • Is a referral required from my primary care physician in order to see Dr. Burke? Is any other pre-authorization required? 
      • Do I have a maximum number of visits, or a maximum dollar amount for this service each year?

If your health insurance coverage does not include naturopathic medical services, you can still receive care. As a courtesy, and to help make quality naturopathic medicine more accessible, Dr. Burke offers a 20% time-of-service discount for patients who are not using insurance benefits for their visits.

What Insurance Plans is Dr. Cori Burke In-Network With?

Dr. Cori Burke is a preferred provider with most major commercial insurance companies including:

  • Aetna
  • American Specialty Health (ASHN)
  • BridgeSpan Health
  • Cigna
  • HealthNet
  • MODA/ODS (Connexus and Synergy plans ONLY. I am not in-network with Beacon plans)
  • Optum
  • Pacific Source
  • Pacific Source Medicare Advantage
  • Providence
  • Providence Medicare Advantage
  • Regence / Blue Cross Blue Shield
  • Regence Medicare Advantage Plans
  • United Healthcare (NOT United Healthcare Community Plan/Apple Health/Medicaid Plans)
  • United Healthcare AARP Medicare Advantage

Medicaid/Oregon Health Plan

In Oregon, our state medicaid program is known as the Oregon Health Plan (OHP). In the Portland metro area, there are many Oregon Health Plan coordinated care organizations (CCO) under the umbrella of Health Share. It’s important to know which CCO you have been assigned before scheduling with a provider, because not all of these plans allow you to see a naturopathic doctor.

Dr. Cori Burke is currently able to provide care for patients with CareOregon and Yamhill Community Care medicaid plans, however she is not considered a primary care provider (PCP). If you have CareOregon or Yamhill Community Care, no referral is necessary to see Dr. Burke.

Dr. Burke is also able to see patients with Providence Health Assurance OHP, but this plan does require getting a referral from your PCP in order to be seen. Please make sure that our office receives a copy of your pre-authorization prior to scheduling your first visit.

Unfortunately, Dr. Burke cannot accept patients with Kaiser Permanente, Legacy Health PacificSource, OHSU Health, Trillium Community Health Plan, Open Card, or any other OHP/Medicaid plan at this time.

Does Health Insurance Cover Telehealth?

Many Medicaid, Medicare, and Commercial health insurance plans cover telehealth services that are provided via video conferencing.

If you would like to schedule a virtual visit with Dr. Cori Burke, you will need to first make sure that Dr. Burke is a covered provider for your plan (see the instructions above for checking your insurance benefits).

If you are not already an established patient with Dr. Burke you may still be able to schedule a telehealth visit to discuss your health concerns. However, since naturopathic medicine is regulated at the state rather than federal level, you do need to be a current Oregon resident in order to have a virtual visit with Dr. Burke.

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