Insurance Reimbursement

As a result of a law passed by the Vermont Legislature in 2007, all insurance companies that are regulated by the state of Vermont are required to reimburse for the services of a naturopathic physician in the same way and to the same extent that they reimburse for the services of any physician. This includes Blue Cross/Blue Shield of Vermont, CIGNA, MVP, Medicaid, VHAP, Dr. Dynasaur, and others. In practice, this means that patients can choose to see a naturopathic physician and get full insurance coverage. With all of these insurers except CIGNA, naturopathic physicians are also eligible to serve as primary care physicians.

This law does not apply to Medicare, out-of-state plans, and certain self-insured employers. The law also doesn’t cover certain procedures such as acupuncture or allergy neutralization treatments unless those procedures are specifically allowed by the plan. It also doesn’t cover natural medicines such nutritional supplements, herbal formulas, and homeopathic remedies.

As with any provider, you may have deductibles and co-pays, and these may be different depending on whether your naturopathic physician is in-network or out-of network with your insurance company. Deductibles and co-pays are generally lower with an in-network provider than out-of-network provider. If you have a managed care plan such as an HMO or POS (if your insurance company required you to choose a primary care physician you probably have a managed care plan), you may also need a referral to see naturopathic physician (unless he or she is your primary care physician). To find out if a naturopathic physician is in your network or if he or she is eligible to be your primary care physician, or about your co-pays or deductibles, contact your insurance company.

 

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