A diabetes diagnosis can be overwhelming. You’ve likely seen your doctor, but maybe you want to work with a dietitian, too.
Maybe you know a dietitian can help control your diabetes, but don’t know how to get set up with one.
Do you search “best diabetes dietitian” and pick one? Do you really need someone who specializes in diabetes? Does your doctor need to tell you where to go? Do they need to provide an official referral?
Healthcare can be confusing and you may be feeling caught in the middle of a system you’re not totally sure how to navigate. The good news is we are here to help.
While the answers to many of the questions above are inevitably, “it depends” we are here to help walk you through how to find these answers.
Here at OnPoint Nutrition, we have helped thousands of people just like you use nutrition to optimize their health. While we are here to help you control your diabetes, we are also here to help you get set up with a provider that fits your needs.
In this article, we’ll help you figure out if you need a referral to see a dietitian. We’ll also give you some strategies for getting the information you need to feel confident in managing your diabetes moving forward.
Do I Need A Referral To See A Dietitian For Diabetes?
To give you the simplest answer to your question, usually, you do not need a referral to see a dietitian.
If you are planning to pay for your nutrition sessions out of pocket, you do not need a referral. Curious about how much a nutrition program costs? Read How Much Does Working With A Dietitian Cost?
However, if you plan to use your health insurance to pay for your sessions with your dietitian your insurance plan and insurance provider will determine if you need a referral.
Health Insurance Coverage For Dietitians 101
Insurance is confusing, so let us give you the basics of using health insurance to cover the cost of your nutrition counseling sessions.
Many major insurance providers offer some coverage for nutrition counseling with a registered dietitian.
One of the key pieces of that sentence is with a registered dietitian. There are many nutritionists and nutrition coaches out there, but health insurance providers require seeing a registered dietitian.
This is because there are education and training standards for registered dietitians that don’t exist for nutritionists and nutrition coaches. Essentially, those titles are not regulated so anyone can be a nutritionist or nutrition coach, while you need to meet specific standards to be a registered dietitian.
Not sure what the difference between a dietitian and a nutritionist is? Read Dietitian vs. Nutritionist: Which Is Best For Diabetes?
Now, if you’ve found a registered dietitian and want to see if your session will be covered, there are seven factors that determine health insurance coverage:
- Your insurance provider
- Your plan-specific benefits
- Referral requirements
- Deductible status
- Potential co-pays
- Coverage limits
- Your place of residence
We won’t go into the nitty-gritty of each of these here, but if you’d like those details read Does Insurance Cover Working With A Dietitian?
You can see that one of the seven factors is referrals, so let’s dive a little deeper here.
Are You Using Health Insurance?
As we mentioned above, if you are using your health insurance to cover the cost of your program, you may need a referral from your doctor.
This doesn’t mean that you cannot see a dietitian without a referral, it just means that your health insurance may not cover the cost of your nutrition sessions if you don’t have one.
Who Is Your Insurance Provider?
Different insurance providers have different standards for coverage.
For example, Medicare Part B requires a referral from a physician for medical nutrition therapy for diabetes with a registered dietitian. However, many private health insurance providers do not.
Unfortunately, the only way to know if you have coverage and if you will need a referral is to ask your insurance company. If you choose to do so, you’ll likely want to ask some of the following questions:
- Does my insurance plan cover medical nutrition therapy with a dietitian for diabetes?
- Do I need a referral to obtain coverage? If so, who can provide the referral?
- Is there a limit to the number of sessions that are covered?
- Will I be required to pay a copay for sessions?
- Given my deductible and/or copays, what will I need to pay out of pocket to see a registered dietitian?
Is There An Easier Way To Find These Answers?
Yes, here at OnPoint Nutrition, we can take care of this for you.
We have a Medical Billing Specialist on our team who will contact your insurance company on your behalf to ask the questions above and help you determine your coverage, including if you need a referral.
We call this process an eligibility check.
How Do I Complete An Eligibility Check?
There are two options for completing your eligibility check.
The first option is to complete an eligibility check to determine your coverage before you schedule a consultation with our team.
To request an eligibility check now, simply fill out this form and click submit.
The second option is to schedule a free consultation with our team, get matched with a registered dietitian, secure a spot on their calendar, and then complete your eligibility check.
If you choose this option, we will complete your eligibility check and explain your coverage to you before you complete your initial session with your dietitian.
Whichever option you choose, we will share all details regarding your insurance coverage with you via email as soon as we receive them.
What’s Next?
We know insurance is confusing, but now you know the facts.
If you are paying for your program out of pocket, you do not need a referral to see a dietitian.
If you are planning to use your health insurance to cover the cost, you may need a referral. That information can be obtained on your own or through our Medical Billing Specialist.
If you are ready to dive into nutrition counseling for diabetes with a registered dietitian, or at least gather some more information, we are here for you.
When you’re ready, schedule your free consultation to take the first step toward managing your diabetes and optimizing your health.
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