Does Your Health Insurance Cover Nutrition Counseling?

Good nutrition is foundational to overall health. Yet, for years, visits with registered dietitians were treated as out-of-pocket luxuries. That’s starting to change.

As chronic diseases like diabetes, obesity, and hypertension drive up health care costs, more insurers are recognizing the value of nutrition counseling as a preventive and therapeutic tool. But does your health insurance actually cover it? Let’s explore.

Coverage Trends Are Improving

Many health insurance plans, especially those compliant with the Affordable Care Act (ACA), now include medical nutrition therapy (also referred to as MNT) when deemed medically necessary. That means if you have a condition like diabetes, kidney disease, or high blood pressure, you may be eligible for fully covered visits with a licensed dietitian.

In fact, the Centers for Medicare & Medicaid Services (CMS) cover MNT for Medicare beneficiaries with diabetes or kidney disease, allowing for 3 hours of one-on-one counseling in the first year and 2 hours annually after that, with no out-of-pocket cost.

For those under 65, the picture is also improving:

• A recent Kaiser Family Foundation report found that nearly 70% of ACA-compliant plans cover some form of nutrition counseling.
• According to the CDC, 6 in 10 Americans live with a chronic disease, many of which are strongly influenced by diet and lifestyle.
• In a 2021 Academy of Nutrition and Dietetics survey, 83% of Americans said they would like their insurance to cover visits with a registered dietitian.

When Is Nutrition Counseling Covered?

Coverage varies by plan and state, but insurers are more likely to approve nutrition counseling when:

• You have a diagnosed medical condition (e.g., diabetes, obesity, hypertension, high cholesterol, kidney disease)
• A physician provides a referral
• The dietitian is in-network and holds the proper credentials (e.g., RD or RDN)

Preventive counseling for general wellness, like improving your diet or losing a few pounds without a medical diagnosis, is less likely to be covered unless your plan includes specific wellness benefits.

Ways to Maximize Your Benefits

If you think you might qualify for covered nutrition counseling, or just want to make the most of your health plan, here are a few practical steps to take. A little preparation can go a long way in avoiding surprise bills and ensuring you're working with the right provider:

1. Check with your insurance provider to confirm what's covered and how many visits are allowed.
2. Ask your primary care physician for a referral if you have a qualifying condition.
3. Look for in-network providers to minimize or eliminate out-of-pocket costs.
4. Consider using HSA or FSA funds if your visit isn’t fully covered.

Final Thought

Nutrition counseling is no longer just a luxury; it’s a medically backed tool to help manage and prevent disease. And the good news? If you have health insurance, there’s a decent chance your plan offers some level of coverage. Take advantage of it. Eating better could improve your health, and save you money in the long run.

Need help reviewing your plan or finding a provider? Reach out to our office. We’re here to help you navigate your health insurance options.