Nutrition Counseling Covered By Insurance
90% of West Coast Dietitian Patients Pay $0 Out-of-Pocket!
FAQ
Many fully-insured Aetna plans cover 10 visits per year for healthy diet counseling and 26 visits per year for overweight and obesity management, often at no cost (or a low cost) to you. Exact coverage depends on your plan details and diagnoses. We’ll help verify your benefits before your first session so you know exactly what’s covered.
Many fully-insured Anthem and Blue Cross Blue Shield plans cover unlimited visits for nutrition counseling, often at no cost (or a low cost) to you. Exact coverage depends on your plan details and diagnoses. We’ll help verify your benefits before your first session so you know exactly what’s covered.
Many fully-insured Blue Shield of California plans cover unlimited visits for diabetes, insulin resistance, metabolic syndrome, and cholesterol management often at no cost (or a low cost) to you. Exact coverage depends on your plan details and diagnoses. We’ll help verify your benefits before your first session so you know exactly what’s covered.
Medicare Part B only covers nutrition counseling for diabetes, chronic kidney disease, or recent kidney transplant. The benefit covers 3 hours of counseling in the first year and 2 hours annually thereafter, requiring a doctor’s referral.
If your medical condition changes, Medicare Part B allows for additional hours of nutrition therapy beyond the standard annual limits. Your treating physician must provide a new referral specifically documenting that your condition, diagnosis, or treatment plan has changed enough to make extra counseling medically necessary.
Many fully-insured UHC plans cover unlimited visits for overweight, obesity, prediabetes, diabetes, cholesterol management, and hypertension often at no cost (or a low cost) to you. Exact coverage depends on your plan details and diagnoses. We’ll help verify your benefits before your first session so you know exactly what’s covered.
At this time, we only accept PPO plans and some EPO/POS plans.
We are currently in the process of becoming contracted with the following HMOs: Affiliated Partners IPA, Allied Pacific IPA, Alpha Care Medical Group, Arroyo Vista Family Health Center, Community Family Care IPA, and Greater Orange County Medical Group.
Cost-Share: The general term for all your out-of-pocket expenses, including deductibles, copayments, and coinsurance.
Deductible (The Threshold): The set amount of money you must pay out-of-pocket for covered services per plan year before your insurance company starts to pay.
Example: If your deductible is $1,000, you pay the first $1,000 of covered services yourself.
Co-Pay (The Flat Fee): A flat fee determined by your insurance that you pay for each session.
Example: A $30 copay for a nutrition session.
Co-Insurance (The Percentage Split): Your share of the costs calculated as a percentage (e.g. 20%) of the allowed amount for the session, usually paid after you have met your deductible.
Example: If a nutrition session costs $100 and you have 20% coinsurance, you pay $20 and the insurance pays $80.
The out-of-pocket maximum (or limit) is the absolute most you will have to pay for covered medical services in a single plan year. Think of it as your financial safety net.
Once you reach this dollar amount through your combined spending on other costs (typically on co-pays, co-insurances, and/or deductibles), your insurance company takes over and pays 100% of all covered, in-network medical bills for the rest of that year .
We require a credit card on file for all clients. This is used for your out-of-pocket costs (like copays, coinsurance, or deductibles) and our $45 late cancellation/no-show fee (applied if you cancel with less than 24 hours’ notice).
While we work hard to maximize your insurance coverage, you are responsible for any fees they don’t cover. We will always notify you before processing a charge and will work with you to keep costs as low as possible.
You can book your first insurance-based nutrition session with us on our booking page.
We will request the following information from you before the start of your session: Photo of your insurance card (front and back)
If you live in CA, we will need to obtain a referral from your doctor prior to your session. Some insurance plans also require a referral in which we will notify this is necessary. We can provide you with a referral form so that your doctor can fill it out.
Insurance coverage for nutrition services applies only to direct, face-to-face time with a dietitian. Any additional benefits provided to patients are offered solely at the discretion of West Coast Dietitian. Services or products that are not covered by insurance will require out-of-pocket payment.
In the event that you carry insurance where West Coast Dietitian is considered out-of-network, you will need to pay for your nutrition session ahead of time. We offer single sessions or packages to our private-pay patients.
Additionally, upon your request, we can provide you with a “superbill”, or an itemized invoice, you can submit to your insurance company for reimbursement. Reimbursement is based on your policy’s standards. Please call your insurance company’s member services number to verify how reimbursement works under your current insurance policy.
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