Insurance
Medical Nutrition Therapy is covered by most insurances. Patients should call their insurance company to see if they have coverage for medical nutrition. We've compiled a list of questions to ask your insurance carrier to help you navigate your benefits and confirm that your visit is covered by your plan.
*Medicare only covers MNT if you have a diabetes diagnosis or chronic kidney disease.
Advocare Nutrition and Diabetes Center is currently in network with the following health insurance plans:
| Aetna |
|---|
| Amerihealth |
| Magna Care |
| CHN |
| Cigna |
| Clover (Medicare Adv.) |
| Horizon BCBS |
| Horizon NJ Health |
| Humana Military |
| IBC/Keystone Health Plan East/Personal Choice |
| Medicare, RR Medicare |
| Medicaid, Oxford |
| Qualcare |
| UHC |
| USFH |
Call the member services number on the back of your insurance card and ask:
- Does my plan cover nutrition counseling (Procedure codes: 97802, 97803, 97804)?
a. Are there nutrition benefits under the preventative care portion of my plan? - Are visits limited to specific diagnosis codes?
a. Are there any restricted diagnosis codes? - Is there a limit to the number of visits (or units) per day/year?
a. Is my plan January to January or does it start a different month? - Do I have a deductible to meet before insurance pays?
a. If so, how much is the deductible?
b. How much of the deductible has been met to date? - Do I have a specialist copay or coinsurance for nutrition counseling?
- Is a doctor’s referral required? (in most cases only a referral is needed for Medicare)
- If interested in telehealth (virtual) visits, ask your insurance if your benefits for telehealth are the same/different than in-office visits.
- If your health insurance plan is not listed above, you can ask if Nicole Lawson, RD (NPI 1699351056) is a covered provider under my plan? If not a covered provider, what are my out-of-network nutrition counseling benefits?
- Record the representative’s name you speak with and a call reference # when checking your benefits. This information will be necessary if you ever need to dispute a rejected claim.
For information on how to obtain insurance coverage for you and/or your family, please visit www.healthcare.gov.
