THE NOURISHED LIFE
Nutrition Therapy and Diabetes CARE
In-Network Insurances Carriers
We are preferred providers for multiple insurance companies. However, that does not mean your specific policy will cover nutritional counseling for your individual diagnosis. The only way to know is by calling the insurance company to “verify coverage and benefits.”
The Nourished Life staff will happily verify your benefits prior to your initial appointment and inform you of your coverage. However, we ask that you do the same since we cannot be held responsible for the cost of services in the event your claim is denied by insurance.
Don’t see your insurance on the list?
Wondering about out-of-state coverage?
Planning to pay in cash instead?
Scroll down to the “Frequently Asked Questions” section for more information.
- Aetna
- Cigna
- CDPHP
- Blue Cross Blue Shield (including Excellus and Empire)
- Fidelis Care Commercial (Essential Plan & Health Benefit Exchange)
- MVP Health Plan
- NYSHIP Empire Plan
- United Healthcare (except Oxford and Compass)
- UPMC Health Plan
Note, Medicare only covers nutrition services for these diagnoses: Diabetes (excludes prediabetes) or Chronic Kidney Disease (stages 3, 4, or 5 without dialysis).
- AARP Medicare Advantage
- Aetna Medicare Advantage
- CDPHP Medicare Advantage
- Excellus Medicare Advantage
- Fidelis Care Medicare Advantage
- Humana Medicare Advantage
- Medicare
- MVP Health Care Medicare Advantage
- United Healthcare Medicare Advantage
- UPMC Health Plan Medicare Advantage
- Aetna Better Health Medicaid Managed Care
- CDPHP Medicaid Managed Care
- Excellus BCBS Medicaid Managed Care
- MVP Health Care Medicaid Managed Care
- United Healthcare Medicaid
- UPMC Health Plan Medicaid Managed Care
Note, unfortunately, The Nourished Life is not in-network with Fidelis Care’s Medicaid Plan. However, we do know three excellent dietitians that we would be happy to refer you to based on your location or telehealth preferences.
- All HSA cards
- All FSA cards
Step-by-Step Guide to Determine Insurance Benefits
Call your insurance company using the phone number located on the back of your insurance card. Request to speak with a representative from member services.
Ask the following questions. Write down the answers as well as the call reference number.
Question 1
Do I have nutrition coverage on my insurance plan?
(CPT 97802, CPT 99404, or CPT S9470)
Question 2
Will my diagnosis be covered?
Always ask about Z71.3.
Other examples that may apply to you: prediabetes, hypertension,
high cholesterol, or overweight/obesity.
Question 3
How many visits do I have per calendar year? When does my "calendar year" renew?
Question 4
Do I have a cost-share for these services? (deductible, copay).
Follow-Up: Have I met my deductible? How much is the copay for nutritional counseling?
Question 5
Do I have telehealth benefits? If so, will I incur an extra cost to use telehealth instead of an in-person visit?
We will happily help you verify benefits. However, we cannot be held responsible in the event your claim is denied by insurance.
The credit card on file will be charged for the outstanding visit.
Frequently Asked Questions
Well, it depends. Most the time, nutrition services are exempt from copays and deductibles. This means insurance will pay for the full cost of your visits regardless whether or not the deductible has been met yet. On the other hand, some policies do require the deductible to be met before insurance will pay anything towards the visit. In the event that you have not met your deductible yet, we will be unable to bill your insurance. Therefore, you will be asked to pay the cash rate at the time of service. We will provide documentation to submit to your insurance company in order to “pay down” your deductible. Once the deductible has been met, we will then directly bill your insurance company for future visits.
Ask your insurance carrier if you have any out-of-network coverage for nutritional counseling. If so, you may be still be eligible to receive reimbursement for your visit through insurance! You will need to pay for the session at the time of service and we will provide a “superbill invoice” for you to submit to insurance directly for personal reimbursement.
If your insurance confirms that you do not have out-of-network coverage, please refer to the prompt pay prices below. Note, HSA and FSA cards are accepted.
If you have a PPO plan, it is very likely that it includes out-of-state coverage for nutritional counseling. Please confirm with your carrier by calling the phone number listed on the back of your insurance card.
Note, due to state licensure regulations, we are only able to provide one-on-one counseling services to patients in the following states: AR, AZ, CA, CO, CT, FL, GA, HI, IN, KS, KY, LA, MA, MS NC, ND, NH, NY, OK, OR, PA, SC, TN, TX, UT, VA, VT, WA, WV, and WY.
But wait! If you live in another state not mentioned, we would be happy to help you find someone licensed in your state.
Right now (2023) due to the recent pandemic most insurances are covering telehealth services. However, it is possible your insurance plan may impose a cost-share for you to use this service. We will ask when we call to verify your insurance benefits. We recommend you do the same.
The prompt pay rates are as follows:
- Initial 90-minute appointment: $150
- Follow-up 60-minute appointment: $100
Discounts are provided for bundled purchases:
- Three 60-minute follow-ups: $270 (save $10/session; $30 total)
- Six 60-minute follow-ups: $480 (save $20/session; $120 total)
We accept cash, check, debit cards, credit cards, and HSA/FSA cards. Please make checks payable to “The Nourished Life LLC.”
You will be asked to pay all applicable co-pays, deductibles, or prompt pay rates at the time of your visit.
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