In Oregon, most commercial/private health insurance companies offer plans that provide coverage & benefits for appointments with Naturopaths/Naturopathic Doctors. Additionally, CareOregon OHP plans are known to cover Naturopathic Medicine.

Naturopathic Doctors are licensed medical providers in the state of Oregon, so many insurance companies cover Naturopathic medical services in the same way they cover an appointment with any other type of physician.

There are many different health insurance plans that offer a wide variety of different coverage & benefits even within the same insurance company. It’s important to be familiar with your own health insurance benefits before seeking care at our clinic.

UNACCEPTED PLANS

• AARP
• VA plans
• All Medicare plans
• All ASH plans
• All Kaiser plans, including Kaiser Medicaid plans
• Cigna
• Oregon Health Plan Open Card
• Trillium Community Health Plan
• Trillium Oregon Health Plan
• Tricare
• Cascade Health Alliance, including Medicaid plans
• Klamath Falls Medicaid
• Regence Legacy LHP Network
• Healthnet
• CHP, including Medicaid plans

ACCEPTED PLANS

• Aetna (including Meridian & Meritain)
• Allied Health
• Regence - including Blue Cross Blue Shield, Premera, (all Blue plans), Regence Group Administrators, Anthem, Bridgespan
• GEHA
• Health Management Association (HMA)
• Providence Health Assurance
• PacificSource Community Solutions
• Regence
• Motor Vehicle Accident Insurance
• Medicaid -  Dr. Ben is no longer accepting Medicaid of any kind.
  • CareOregon
  • OHSU Moda Medicaid
  • PacificSource Community Solutions Medicaid
  • Providence Heath Assurance Medicaid
  • Yamhill CCO 

OUT-OF-NETWORK BUT ACCEPTED: 

• Moda - including Connexus, Synergy, OHSU & Tualaltiy Health Community Network
  • We will be in-network with Moda insurance plans starting 11.01.23.
• United Healthcare (UHC)

Ultimately, it is the patient’s responsibility to know what their benefits are. Please remember, “Covered” does not always mean” Pay” and copay’s may be different for an exam than a spinal manipulation. Your insurance benefits are not a guarantee of payment; they are only a quote from your insurance company. We will make every effort to follow benefit guidelines. Although, you are still responsible for making sure that all required authorizations, pre-certifications and physician’s prescriptions are in order prior to and during treatment.

Since the insurance world likes to change things for all of us (both patients & health care workers) without notice, it’s inevitable that something may fall through the cracks when it comes to insurance coverage. Here are a few examples of what may happen :

• Prior Authorization is/was required.
• Referral from your Primary Care Provider is/was required.
• Underpayments leading to an Outstanding Balance can occur if your plan/coverage changed.

We want your insurance to work with you, not against you!

Understand Your Insurance Responsibility

How to Check Your Benefits for Naturopathic Medicine & Dietician/Nutrition Coverage

If you’d like to find out if your insurance plan offers benefits & coverage for Naturopathic &/or Dietician/Nutrition medical services, here are a few things you can do:

1. Review your insurance plan portal, handbook & policies.

• Sometimes your insurance plan documents will specifically say if Naturopathy/Naturopathic Medicine &/or Dietitian/Nutrition is covered.
• If you have an HMO plan you may be limited to seeing providers who work for that company (for example Kaiser). In most cases these plans will not cover naturopathic medicine.

2. Call your insurance company.
To check your insurance benefits, call the customer service number on the back of your insurance card. Ask for benefits/coverage/eligibility. Tell the phone representative you’re calling to verify your insurance benefits & coverage.

Here is a general list of the questions you may want to ask your insurance:

• Does my policy cover services that are performed by a licensed Physician &/or Dietitian?  (If your insurance is unsure, you can ask if your policy specifically excludes Naturopaths as covered providers in its definition of physician.)
• Is there a specific deductible I need to meet in regards to these services?
• How much of my deductible do I still have to meet this year?
• Is <Provider's Name> in-network with my specific plan?
• What is my copay or coinsurance in regards to these services?
• Is a referral required from my Primary Care Physician in order to see <Provider's Name>?
• Is there any other pre-authorization required?
• Do I have a maximum number of visits, or a maximum dollar amount for these services each year?
• If your health insurance plan does not cover Naturopathic &/or Dietician/Nutrition services, you can still make an appointment! Please review our out-of-pocket/cash rate below!
• Specialist vs. PCP :: We are not credentialed & considered as primary care providers (PCPs with any insurance company. We also do not bill as PCPs. We’re credentialed as, considered as & bill as Specialists - Naturopathic Doctors. As mentioned on our website & on our New Patient Application as a statement you agreed to to confirm your application: "We offer primary care services, but according to commercial insurance, we are not defined as a primary care physician (PCP): we are defined as specialists (naturopathic physicians).”

This visit includes 55/60minutes of time spent together either virtually or in person. This includes out-of-state clients as well. A comprehensive history is taken and labs/imaging are ordered, if necessary or indicated. Initial treatment guidelines are initiated and goals are defined.

Will be discussed during your first visit.

Specialty labs are generally not covered by insurance, but as a courtesy, we’ll provide you with a superbill, if you request one, that you can submit yourself to your insurance to try to get reimbursement. Fees for laboratory testing are not included in the cost of office visits. Conventional tests may be covered by your insurance provider, although cannot guarantee coverage. Fees for laboratory testing are not included in the cost of appointments. Lab test pricing and insurance reimbursement depend on the specific test, insurance benefits/coverage, and laboratory used. 

We do our best to be conscious of using insurance, HSA, etc. when possible and only order what we deem necessary.  If you don’t have insurance and will be paying out-of-pocket, we contract with discount labs and can provide transparent pricing. Comprehensive blood work typically prices will vary. Payment for appointments do NOT include potential on-site blood draw, urine dip, cost of labs, imaging, &/or supplements.

If you plan to to pay out-of-pocket for labwork, we recommend Ulta Labs :: Instead of paying a lab you visit to complete your lab order we create for you, you can use Ulta Labs for much cheaper! Note: Ulta Labs works primarily with Quest labs.

The Carroll Food Intolerance Evaluation is never & not covered by insurance of any kind. This is an out-of-pocket cost.

Private insurance benefits typically cover all or most of the cost of prescription medications. Compounded medications may not be covered. Contact your insurance carrier for details. Generally, I cannot prescribe medications for clients/patients that live out of the state of Oregon unless you can pick up the RX in Oregon.

The cost of supplements vary. Supplements are required to be paid in full before they're given out.

Non-lab specialty testing prices will vary. They are rarely/never covered by insurance. Specialty testing kits are required to be paid in full before they're given out.

We offer Square Afterpay payment plans for balances over a certain amount. Payment plans will include a 3% fee (we are charged 6% to offer payment plans but we handle half of the fee, 3%, to make it more accessible).

We accept credit cards, debit cards, checks, ACH bank transfers, Cash App through Square, as well as cash.

Payment Plans :: We offer Square Afterpay payment plans for balances over a certain amount. Payment plans will include a 3% fee.