Update on Insurance Coverage for Naturopathic Doctors in the State of Maine

It has been over a year now since the Affordable Healthcare Act (ACA) was implemented at the Federal level of government. Section 2706 of the ACA provides for a non-exclusion clause, wherein private insurance companies such as Anthem, Cigna, Aetna, Harvard Pilgrim and United Healthcare are mandated to provide in-network coverage for all licensed healthcare professionals, including Naturopathic Doctors. Unfortunately, Governor LePage’s administration has yet to enforce this mandate in the State of Maine. The Maine Association of Naturopathic Doctors (MAND) has been working diligently to seek inroads into ensuring that the ACA mandate is followed.

SEC. 2706. NON-DISCRIMINATION IN HEALTH CARE.
(a) PROVIDERS.—A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.

It only makes good rational sense that subscribers to the private insurance plans listed above should have the ability to decide which healthcare professionals their insurance should cover. It also makes sense that insurance providers would want to encourage their subscribers to use preventive medicine and avoid large health emergency expenditures. As many of our patients are aware, NENH and other Naturopathic Doctors offices in the state of Maine are currently conducting a postcard campaign in order to make the voices of insurance subscribers heard. These postcards, available in our office and many others, state that consumers want the federal mandate of 2706 enforced so that Naturopathic Services are covered by their insurance plans. MAND is now also considering introducing a bill for the next legislative session (2016) in order to force compliance with 2706.

Here’s what you can do to support this effort and ensure that your voice as a consumer is heard:

Stop by NENH and fill out one of the postcards, or call the office and we can fill one out on your behalf

Contact your local legislator and make them aware that you would like the federal mandate of 2706 enforced in the State of Maine

Contact your insurance company and tell them that you would like your insurance benefits to extend to Naturopathic Doctors and that excluding this coverage is currently against the law

Switch your insurance coverage to Maine Community Health Options, a cooperative insurance program that already provides in-network coverage
for Naturopathic Doctors

Don’t forget that the most important thing to Health Insurance providers is you, the consumer. Make your voice heard and demand that the law put forth by section 2706 of the ACA is followed. Let’s see what we can accomplish when we all work together toward this common goal.

As a reminder, if you use Naturopathic Healthcare and have private health insurance other than MCHO, you can request a billing summary for your out-of-pocket expenses. You can then submit this summary to your insurance company for reimbursement. Many of our patients are partially or fully reimbursed for out-of-pocket expenses at NENH. We encourage you to use this service, as the more documentation of Naturopathic services received by insurance providers, the higher the awareness of consumer demand.