Does Insurance Cover Functional Medicine?

Individual practices and decisions vary by clinic and/or provider but, generally speaking, functional medicine raleigh north carolina visits and treatments are not covered by health insurance plans. This can raise a red flag for some: if health insurance plans do not cover functional medicine assessments and treatments, does that mean this is not real health care? In short, no. If anything, functional medicine uses even more elements of well-studied, scientifically proven methods of both assessing and treating those living with chronic diseases. It can also help prevent disease by effectuating targeted behavioral and lifestyle interventions that cost little to nothing (other than groceries and walking shoes, perhaps).

Why Doesn’t Insurance Cover Functional Medicine?

In fact, it is because functional medicine doctors take such a comprehensive, holistic view of each patient and the various factors that contribute to their health that these visits simply don’t fit into the one-size-fits-all coding practices of today’s health insurance companies. Whereas this system takes each person and boils them down to the disease that has manifested in their body as a simple means of plugging a number into a computer to bill for it, functional medicine practitioners actually take the time to get to know their patients and the challenges that they face in order to recommend treatment plans that can vastly improve their overall health and quality of life. There is no simple code for this kind of complex treatment, which is why most functional medicine practitioners simply forego the time and money it takes to cajole insurance companies into submission and create means of seeing and treating patients as inexpensively as possible.

Benefits of Bypassing Insurance Plans

While it may sound like a downside, bypassing insurance plans can actually be quite beneficial for patients. Some of the biggest benefits to working outside of the confines of the health care insurance industry include vastly improved flexibility, transparency, and personalization.

Rather than being limited by the typical 15-minute appointment times that insurance companies will cover, working outside this system allows providers to set lengthier and more flexible windows of time to meet with their patients. It is not uncommon for a visit with a functional medicine doctor – particularly in the early stages of intake and plan creation – to last an hour or more. This allows your provider to actually get to know you and understand your overall health before working to address it. It also allows for meetings that might not typically be covered by insurance, such as phone or video visits that might work better with a patient’s schedule.

Bypassing insurance also allows for more transparent billing, and patients can work directly with their doctor to decide which tests are necessary and how much they will pay for each one. Oftentimes, payment plans can be set up directly via a provider’s office; Health Savings and other flexible benefits plans can even be used to pay for visits and supplements.

All of this works together to create a much more personalized – and therefore effective – health care treatment experience. Armed with all of the knowledge you need, you and your provider can then work together to create a plan that will work for you at a price you can afford.

Functional Medicine vs Traditional Doctors