Does insurance cover registered dietitians and nutritionists?

Nutrition experts are often unsung heroes of healthcare. They may not get the same attention as other specialists, but working with one can make a major difference in your well-being by helping you choose the right foods for your goals in a realistic, sustainable way. But does insurance cover nutritionists andregistered dietitians? Here’s what you should know.

For many people, the answer is yes. “Coverage can vary by provider and by plan, but most insurance plans will cover 100% of all nutrition services,” says Alex Caspero, R.D., a St. Louis-based registered dietitian. This is especially true for what’s known as medical nutrition therapy (MNT), which is when a dietitian helps you manage or treat a specific medical condition, such as diabetes, hypertension, and eating disorders.

There are other reasons you’d see a dietitian — prenatal nutrition counseling, concern about a food sensitivity, general help improving your diet — and many insurance companies consider those visits a preventive service, which they may also cover. “I always recommend that clients talk to their insurance provider to see what's covered. You may be surprised at what nutrition services you are eligible for,” Caspero says.

If your insurance doesn't cover dietitian visits, “you may be able to use your flexible spending account (FSA) or health savings account (HSA) funds to pay for these services,” says Danielle Crumble Smith, R.D., a registered dietitian in Flintstone, Georgia. “These accounts allow you to use pre-tax dollars for eligible medical expenses, including nutrition counseling in some cases.”

Medicare Part B, a type of government-provided medical insurance, covers 100% of “medical nutrition therapy” for three groups at this time:

• Individuals who have been diagnosed with diabetes

• Those with renal disease

• People who have had a kidney transplant in the past three years

A doctor referral is required, and the registered dietitian needs to meet certain criteria to be fully covered by Medicare.

Medicaid may cover nutrition counseling for people with prediabetes who take part in theNational Diabetes Prevention Program (DPP). The DPP’s “lifestyle change program” includes coaching on healthy eating habits. At the moment, DPP is only covered by Medicaid plans in 22 states and the District of Columbia. For most members who are not part of a DPP, though, Medicaid typically does not cover dietitian visits.

Coverage is far less common for nutritionists than it is for registered dietitians because of the big difference in their training. “Nutritionists without credentials won't be eligible for insurance reimbursement,” Caspero says. Some insurance plans might cover nutrition counseling from licensed nutritionists or if they’re a “health coach” that’s part of a larger medical program that includes other medical professionals, such as doctors and personal trainers. However, in most cases, nutritionist appointments will be out of pocket (or out of your FSA or HSA account).

There’s a reason insurance tends to cover dietitian services but not visits with a nutritionist. And it comes down to the difference between the two in terms of qualifications and education requirements. A registered dietitian (R.D.) or registered dietitian nutritionist (RDN) “have met rigorous educational, training, and certification standards, making them qualified to work in medical and clinical settings,” Smith says.

To be a R.D. or RDN — the two are interchangeable — an individual must:

• Complete a bachelor's degree in nutrition, dietetics, or a related field from an accredited institution. Many R.D.s and RDNs also go on to get a Master’s degree and starting in 2024 they will be required to have one.

• Complete 1,200 hours of an accredited, supervised practice program (similar to an internship).

• Pass a national examination administered by theCommission on Dietetic Registration (CDR).

• Complete 75 hours of continuing education requirements every five years to keep up with the latest nutritional guidelines and research.

Due to this training, R.D.s and RDNs are qualified to provide medical nutrition therapy (MNT). A nutritionist, on the other hand, is not a title that’s regulated, so anyone can claim to be one, even if they only have minimal training (such as an online certificate). Some nutritionists may have extensive education and credentials, but you’d have to do your homework to make sure.

If you don’t have health insurance or your plan doesn’t cover seeing a dietitian, you have options. “Health insurance is not necessarily required to see a registered dietitian,” Smith says. Many dietitians will still see uninsured patients, and visits can generally cost between $50 and $150. To lower costs, consider asking about group counseling, online dietitian services, or, if you qualify, going to a community or university health center.

The first place to start is reviewing your insurance policy and benefits booklet, which is usually accessible online. This should include sections for "nutrition counseling," "preventive services," or "medical nutrition therapy,” Smith says. If you can’t find what you’re looking for, “call the customer service number on the back of your insurance card and inquire about their specific benefits,” Smith recommends.

Here are some of the questions Caspero and Smith recommend asking to get a better understanding of your coverage:

• Does my plan cover visits to a registered dietitian?

• Are there any specific conditions or reasons for the visit that are covered?

• Do I need a referral from my primary care physician?

• Are there limits on the number of visits covered?

• Are telehealth nutrition services covered?

• Is pre-authorization required?

• Are there any out-of-pocket costs or co-pays I should know about?

Your dietitian may also be able to help you figure out your insurance coverage and estimate potential costs, Smith adds.

There are several resources that can help you find a dietitian that’s covered by insurance:

• Use your insurance company’s "Find a Provider" tool, which should allow you to search for in-network registered dietitians.

• Call your insurance company’s customer service number and ask for a list of covered providers.

• Ask your primary care physician for a referral.

• Check out The Academy of Nutrition and Dietetics’"Find an Expert" toolto sort by location and specialty, then call the dietitian to ask about insurance coverage.

• The easiest? Going through WeightWatchers!We now offer members virtual visits with registered dietitians, which may be covered by insurance. Simply tap "Clinic" in your WW app or visit ourdietitianspage to learn more.

Dietitian services can be helpful for many individuals, including those with and without chronic health conditions. And many nutrition-related services are covered by medical insurance. For the best chances of having your nutrition counseling covered, see a registered dietitian (as shown by having an R.D. or RDN after their name) and reach out to your insurance company to confirm what kinds of services are covered.