Please refer to recent developments in Vermont legislation regarding private insurance coverage for naturopathic medicine: Insurance Reimbursement Bill info
Ensuring your Coverage with a licensed
Naturopathic Physician
When you speak to your insurance company, make sure they know you
would like Naturopathic services covered. You will need to clarify
your:
· copay on each service
· deductible
· coverage of services: visits, pharmacy, laboratory
· ensure that the insurance company understands that you would
like Naturopathic pharmacy covered. Naturopathic pharmacy is not the
same as prescription pharmacy. Your card may say that pharmacy is
covered, but it still may not cover your Naturopathic treatments.
If your employer writes their own policy, they will determine what
the parameters of coverage will be.
Discuss your needs and you insurance plan with the person who manages
the insurance in your place of employment.
The companies listed in the following have many different plans
and riders available. In discussion with them, you will negotiate
what best fits your needs in terms of coverage for licensed Naturopathic
Physicians.
For more information on the above companies, contact the Vermont
Department of Banking, Insurance, Securities, and Heath Care Administration
at: 802 828 3301 and ask for a copy of the Consumer Tips pamphlet
entitled Shopping for Individual or Small Group Health Insurance
in Vermont. You can also view this information on-line at www.bishca.state.vt.us.
The pamphlet includes rates and contact information for most of
the above companies.
Insurance Coverage for Naturopathic Care in Vermont
Services to be covered
· Patient Visit
· Pharmacy
· Laboratory costs
Terminology
Coverage is for individuals, small groups, large groups, or will
be employer funded. Employer funded administrators hold an account
for the group and draw funds out of that account to cover the care
as it is utilized.
Plans Available to Patients in Vermont
Coverage In Network
In network means that your Naturopath has agreed to a contract with
the insurance company. The result of this is that you should receive
more coverage for services at a lower deductible rate. Your Naturopath
has agreed to the fees set by the insurance company and will submit
your insurance forms
· CBA (affiliated with Blue Cross/Blue Shield) : employer
can write their own policy and choose what services will be covered.
CBA are employer funded administrators.
· NAP (box 9501 only): all services may be covered depending
on the plan. This company offers coverage to individuals, small
groups, large groups, and employer funded groups.
· Guardian: offer small group coverage.
· Core Source Lancaster: are employer funded administrators.
Out of Network
This means that your Naturopath may or may not submit your insurance
forms to your insurance company. Ask at your doctor's office for
their current procedure. You may be given a ICD-9 code and a superbill
to submit yourself.
· Choice Plus of Vermont (small and large sized businesses):
employer can write their own policy and choose what services to
cover.
· London Health Administrators: Naturopathic policy can cover
all services.
· Cigna: has covered visits and laboratory cost in some cases.
They offer individual, small and large group policies
· VHAP: has covered visits in some cases.
· NE Financial: offer small and large group, and individual
policies
· Guardian: offer small group polices
· Phoenix American Life: offer large group policies
· Chickering Claims Administrators: are employer funded administrators.
· Employee Benefits Administrators: are employer funded administrators
The following groups have "no network" in Vermont. This
means they offer no in state policies for any medical provider in
this state. They have been known to cover naturopathic services
when bills have been submitted.
· Mutual of Omaha: individual policies.
· John Alden: individual and small group policies.
· Aetna: individual policies.
· International Union: individual policies.
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Insurance
