MEDICARE PART B
– Nutrition therapy is ONLY covered with a diagnosis of diabetes or pre-dialysis kidney disease. Medicare does not cover pre-diabetes or any other diagnoses.
– Medicare limits the amount of nutrition therapy to 3 hours for the first calendar year, whether is was provided by us, another dietitian, or a combination of both. Medicare limits the amount of nutrition therapy to 2 hours for subsequent calendar years. Additional visits are covered when there is a change in your condition and your doctor sends us a new referral.
– A referral from your Medicare doctor (MD or DO) is always required. Have your doctor’s office fax it to us as (866) 266-4118. It is the client’s responsibility to ensure the referral has been received prior to any scheduled appointments.
– Telehealth is being covered during COVID-19.
MEDICARE ADVANTAGE PLANS (a.k.a. Medicare Part C)
– These plans are offered through private insurance companies like BCBS, Aetna, etc. The insurance company is billed, not Medicare. Thus, if we are not contracted with the private insurance company we cannot bill them for you. You will pay for your visit up-front and, upon request, we will give you a superbill to submit for possible reimbursement.
– Medicare Advantage Plans may cover additional diagnoses that straight Medicare does not and may also cover more visits.
– A referral is still required.
– We are currently in-network with many Medicare Advantage Plans.
MEDICARE SUPPLEMENT PLANS (a.k.a. MediGap)
– These plans do not provide any additional benefits beyond straight Medicare. If straight Medicare won’t cover it, a Medicare Supplement won’t either. These plans only help cover copays, which don’t apply to nutrition therapy anyway.
Feel free to send a picture of your insurance card(s) to Sara@NutritionSara.com and I will let you know if I identify any issues with coverage. Doing this is NOT a replacement for calling your insurance.