People frequently ask about the coverage of naturopathic medicine by extended health insurance plans. Due to the variability between different plans, below are questions that you can ask your insurance provider about coverage to see a naturopathic doctor.

How much naturopathic coverage do I have with my insurance plan?
Most insurance plans provide a certain amount of coverage to see a naturopathic doctor per year (e.g. $500 per year).

Does the extended health insurance plan provide coverage on a fiscal year or on a calendar year?
Different insurance plans work either on a fiscal year (e.g. June 1, 2012 to May 31, 2013) or on a calendar year (e.g. January 1, 2013 to December 31, 2013). From my experience, most patients in Ottawa have coverage based on a calendar year.

Is there a limit to the amount covered per visit?
Some plans do limit the amount of coverage per visit to see a naturopathic doctor. These are some examples of limitations that insurance companies have.

      1- Dollar amount per visit (e.g. $80)
      2- Percentage of fee covered (e.g. 80% of visit is covered)
    3- Dollar amount per visit based on length of appointment (e.g. max payment of $120 per hour)

While some insurance plans do limit coverage on an amount per visit basis, most plans limit the yearly claimable maximum amount.

Is a referral from your family medical doctor required in order to see a naturopathic doctor?

A referral form is not typically required in order to be reimbursed for seeing a naturopath.
That being said, more insurance providers are now requiring medical notes to see different health care professionals (e.g. psychologist, physiotherapist, chiropractor, registered massage therapist, acupuncturist, etc), in order to be reimbursed for services .

How do I submit a claim for a visit with a naturopathic doctor?
Most insurance companies will have a form that you are able to download from their website. To complete this form, you will need to have your plan contract number and your plan member certificate number. If you have trouble finding either of these, ask your extended insurance provider or your human resource director for assistance.

In addition to the completed form, most insurance companies require a receipt from the naturopath that clearly states the name of the naturopath, their license number and their contact information.

The majority of extended health care plans require that the claim forms and receipts be submitted by mail, while other require online submission.

How long does it take to get reimbursed after submitting the appropriate forms and receipts?
This may vary between insurance providers, but most insurance companies will process and reimburse the claim within 2 weeks of receiving it. The method of reimbursement varies, with most insurance companies mailing a cheque, while others will directly deposit the funds into your bank account.

Can my insurance coverage be changed?
Some insurance providers do offer different levels of coverage. With these plans, there is an additional amount that you can pay to purchase better coverage. For the majority of patients a higher level of coverage is not required, and is only worth purchasing if you will use the additional coverage.

If you are calling your extended health care insurance provider about coverage to see a naturopathic doctor, it is best to also ask about other services that you are covered for:

  • Dentistry
  • Physiotherapy
  • Psychology
  • Osteopathy
  • Chiropody
  • Chiropractic
  • Registered massage therapist
  • Acupuncturist
  • Registered dietitian
  • Speech language pathologist

If you have any questions about naturopathic medicine, or how it can help you, please call 613-290-6115. Graham Beaton is a naturopathic doctor practicing in Ottawa.