If you’re seeking natural care to manage a condition or prevent future health issues, one essential question could determine your next step: Does my insurance cover naturopathic doctors?
The answer varies widely depending on your location and insurance plan. Let’s break it down, starting with the basics of coverage for naturopathic services.
Which jurisdictions regulate NDs?
Twenty-six states license and regulate naturopathic practice (green states in the map below).
In Canada, seven jurisdictions (six provinces and one territory) regulate naturopathic medicine: British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Nova Scotia, and the Northwest Territories.1Common Questions, Education and Regulation. Canadian Association of Naturopathic Doctors. Published December 7, 2021. Accessed October 9, 2024. https://www.cand.ca/common-questions-education-and-regulation
Acquiring a license or registration to practice is a multi-step process. To be eligible, NDs must meet the following criteria:
- Graduate from an accredited, four-year residential naturopathic medical program
- Pass the NPLEX, an extensive postdoctoral board examination
- Pass Entry-to-Practice exams, if regionally required
If you live in an area where naturopathic doctors aren’t regulated, you can still access care. That’s because many NDs are licensed in states or provinces where the profession is regulated. For example, patients in North Carolina (not yet regulated) can consult NDs who live locally but keep a current license from a state like Connecticut or Vermont (both regulated).
It’s important to note that naturopathic doctors cannot legally diagnose or treat diseases in unregulated jurisdictions. Their scope of practice—what services they can provide, medicines they can prescribe, and tests they can order—varies by state. To learn more, check with your region’s naturopathic association or regulatory board.
Where are NDs called primary care providers?
Twelve states formally recognize NDs as primary care providers (green states in the map below). Why does this matter? Because private insurance companies may require a primary care designation to determine whether services are covered.
Do government health insurance programs cover NDs?
Naturopathic doctors are not recognized as eligible practitioners under Medicare, which doesn’t cover naturopathic services. Medicare’s definition of “physician” includes medical doctors (MDs), doctors of osteopathy, dentists, podiatrists, optometrists, and chiropractors.
At the state level, Medicaid coverage for naturopathic care is limited. Five states provide Medicaid for people of all ages, while Arizona offers coverage only for minors. Expanding ND licensure under Medicaid would help more people in rural areas and families with limited income get regular care.
If you’re eligible for Medicaid and live in one of the states above, contact your health or Medicaid authority to learn more about covered services. Medicaid sometimes covers benefits Medicare won’t, and people typically aren’t required to pay out of pocket (although certain services may have a small co-pay).
Coverage for veterans
Naturopathic medicine’s whole-person approach addresses the complex health needs of veterans, such as chronic pain, fatigue, insomnia, and depression. Veterans Affairs Canada covers consultations and assessments for approved naturopathic doctors registered with appropriate insurance agencies.2Naturopathic Benefit FAQ. Veterans Affairs Canada. Accessed October 9, 2024. https://veterans.gc.ca/en/mental-and-physical-health/physical-health-and-wellness/medical-costs/coverage-services-prescriptions-and-devices/naturopathic-benefit-faq
Government health coverage in Canada
Canada’s health care is regulated mainly at the provincial level. Currently, no provinces or territories provide government coverage for naturopathic care.1Common Questions, Education and Regulation. Canadian Association of Naturopathic Doctors. Published December 7, 2021. Accessed October 9, 2024. https://www.cand.ca/common-questions-education-and-regulation Patients typically pay out of pocket or with private insurance from their employer.
However, under the Medical Expense Credit, most Canadians can claim naturopathic services on their tax returns.3Authorized Medical Practitioners for the Purposes of the Medical Expense Tax Credit. Canada Revenue Agency. January 4, 2016. Accessed October 9, 2024. https://www.canada.ca/en/revenue-agency/services/tax/individuals/topics/about-your-tax-return/tax-return/completing-a-tax-return/deductions-credits-expenses/lines-33099-33199-eligible-medical-expenses-you-claim-on-your-tax-return/authorized-medical-practitioners-purposes-medical-expense-tax-credit.html
Does private health insurance cover naturopathic doctors?
The answer depends on where you live and the kind of insurance you carry. About twelve U.S. states offer some private coverage for naturopathic services (green states below).
Five questions to ask your insurer
If you live in a state with private insurance coverage for naturopathic treatment, start by confirming whether naturopathic doctors are recognized as primary care providers in your jurisdiction (see second map, above). Then, contact your insurer to clarify coverage details.
Here are some key policy questions:
- Does my policy cover naturopathic services? Is a specific designation necessary (such as a naturopathic doctor or naturopathic physician)?
- Does my policy cover naturopathic visits only, or are supplements, lab tests, and other recommended treatments included?
- What are my maximum benefits per visit and year?
- Should I pay for naturopathic services out of pocket before submitting a claim, or can services be preapproved?
- Is a letter of medical necessity required to claim naturopathic services or treatments?
In Canada, private coverage depends on your employer’s specific policy, not your province. Naturopathic services are often classified as “paramedical,” with annual or per-visit limits. However, many insurers are expanding coverage, recognizing that naturopathic care can reduce costs for the public health system by offering alternatives to expensive drugs and procedures.
Canadians should consult their employer’s insurance representative or insurer to understand policy and payment options. It’s also worth asking if additional options like health spending accounts cover services beyond standard plans.4Common Questions, Naturopathic Visits. Canadian Association of Naturopathic Doctors. Published December 7, 2021. Accessed October 9, 2024. https://www.cand.ca/common-questions-naturopathic-visits
Three questions for your naturopathic doctor
When you know which services are covered, what documentation is required, and how payments are handled, check in with your ND to determine how insurance coverage works at their clinic.
What to ask your ND:
- Do you accept private insurance?
- Do I have to pay for services right away?
- Can you provide the documents (e.g., superbill invoice, medical necessity letter, listed recommended treatments) requested by my insurance carrier?
In Canada, the first question is more of a formality. Because naturopathic services do not qualify for public health coverage, most NDs accept private insurance.4Common Questions, Naturopathic Visits. Canadian Association of Naturopathic Doctors. Published December 7, 2021. Accessed October 9, 2024. https://www.cand.ca/common-questions-naturopathic-visits
Regulatory efforts for naturopathic doctors are moving forward in the United States, with 10 states actively pursuing licensure initiatives, two planning advocacy campaigns for 2025, and grassroots efforts under way in about five others. Work to establish state affiliates is ongoing in nine states.
At the federal level, the American Association for Naturopathic Physicians’ Federal Recognition Campaign seeks to amend the Social Security Act with licensed naturopathic doctors in the definition of “physician.” This change would enable NDs to address provider shortages, fill healthcare job vacancies, and deliver whole-person care to Medicare populations and underserved communities.
The Canadian Association of Naturopathic Doctors (CAND) advocates ND licensure and regulation in unregulated provinces and territories. CAND works with insurance providers to improve coverage for naturopathic services, recognizing the value NDs bring to patient care and the potential for more efficient health spending.
Now that you know what types of insurance cover naturopathic services, the next step is finding the right provider to guide your whole-person health journey. Start by exploring our Find an ND database to connect with licensed naturopathic doctors in your area.
Footnotes
- 1Common Questions, Education and Regulation. Canadian Association of Naturopathic Doctors. Published December 7, 2021. Accessed October 9, 2024. https://www.cand.ca/common-questions-education-and-regulation
- 2Naturopathic Benefit FAQ. Veterans Affairs Canada. Accessed October 9, 2024. https://veterans.gc.ca/en/mental-and-physical-health/physical-health-and-wellness/medical-costs/coverage-services-prescriptions-and-devices/naturopathic-benefit-faq
- 3Authorized Medical Practitioners for the Purposes of the Medical Expense Tax Credit. Canada Revenue Agency. January 4, 2016. Accessed October 9, 2024. https://www.canada.ca/en/revenue-agency/services/tax/individuals/topics/about-your-tax-return/tax-return/completing-a-tax-return/deductions-credits-expenses/lines-33099-33199-eligible-medical-expenses-you-claim-on-your-tax-return/authorized-medical-practitioners-purposes-medical-expense-tax-credit.html
- 4Common Questions, Naturopathic Visits. Canadian Association of Naturopathic Doctors. Published December 7, 2021. Accessed October 9, 2024. https://www.cand.ca/common-questions-naturopathic-visits
