Does Health Insurance Cover Naturopathic Medicine?

In Oregon, most commercial health insurance companies offer plans that cover office visits with naturopathic doctors. Additionally, CareOregon OHP plans also cover natruopathic 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.

Does Health Insurance Cover Telemedicine?

Many Medicaid, Medicare, and Commercial health insurance plans cover telemedicine services provided via video conference or telephone.

If you would like to schedule a telehealth visit with Dr. Cori Burke during the COVID-19 pandemic, you will need to first make sure that Dr. Burke is a covered provider for your plan (see instructions below for checking insurance benefits).

If you are not already an established patient with Dr. Burke you may still be able to schedule a virtual 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.

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:

  • Read more about insurance coverage of naturopathic physicians in Oregon from the Oregon Association of Naturopathic Physicians
  • 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?
      • Is Dr. Burke considered a specialist or a primary care provider (PCP) for my plan?
        • This difference may effect your copay and whether or not the cost of the visit is applied to your deductible.
      • What is my co-pay or co-insurance?
      • Is a referral required from my primary care physician in order to see Dr. Burke? 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 policy does not cover naturopathic medical services, you can still receive care. Dr. Burke offers time-of-service discounts for patients who are not using insurance benefits.

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

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

  • Aetna
  • American Specialty Health (ASH)
  • BridgeSpan Health
  • Cigna
  • HealthNet
  • MODA/ODS (Connexus and Synergy plans ONLY)
  • 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 Medicare Advantage

Medicaid/Oregon Health Plan

In the Portland area there are many Oregon Health Plan Coordinated Care Organizations (CCOs) under the umbrella of Health Share.

Dr. Burke is currently able to provide care for patients with CareOregon (Oregon Health Plan / OHP) as an out-of-network provider, however she is not a primary care provider (PCP) for CareOregon.

Dr. Burke is also able to see patients with Providence Medicaid/Health Share but this plan requires getting an authorization from your PCP.

Unfortunately, Dr. Burke cannot accept patients with any other OHP/Medicaid plan at this time.

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