Insurance Coverage for ROHP
Many practitioners ask if group benefit plans cover nutritional counseling provided by a Registered Orthomolecular Health Practitioner (ROHP) and a Registered Nutritional Consulting Practitioner (RNCP), who have an active registration number with the IONC (International Organization of Nutritional
Consultants – www.ionc.org).
In discussions with the IONC, and based on my personal experience as an ROHP, here is the answer to the question:
- For patients who are in unions (almost 5 million working Canadians as of 2015 https://www.canada.ca/en/employment-social-development/services/collective-bargaining-data/reports/union-coverage.html), including many government workers, where the group benefit plans are self-funded (the members fund the plan through contributions and no insurance company is involved in the underwriting of the plan), the plan adjudicators are obliged to keep the plan member (employee) happy. Even if not implicitly stated in the group benefit plan booklet, in at least 50% of cases adjudicators reimburse the plan member (employee) for nutritional counseling fees provided by an ROHP or RNCP, provided an active IONC registration number is present on the receipt. This is separate from any chiropractic coverage, whereby billing would be done using the Chiropractic Registration number, not the ROHP/RNCP Registration Number.Most union plans have an allowance for nutritional counseling services, or other wellness/health-promotion allowances, which can be used to reimburse the member (employee) for nutrition counseling sessions up to a certain maximum. I generally charge $150 – $250 for the initial consultation and $50 – $75 for follow-up visits. My weight-loss program is $600, which provides weekly visits for 8-consecutive weeks.An important reason why these plans tend to reimburse members (employees) for ROHP/RNCP nutritional counseling and weight-loss coaching is because plan sponsors (Third Party Administrators who design and adjudicate these plans and track trends) are aware that faulty diet and lifestyle factors are important determinants and predictors of chronic degenerative disease onset leading to increased absenteeism, increased drug costs and long-term disability claims, which are costing the benefit plan more money every year. As a rule, they encourage any initiative the member (employee) embraces that will improve their dietary and exercise behaviours, reduce excess body fat and improve fitness. So, there is usually very little push back when a member (employee) exhibits proactive dietary and exercise measures to improve their health status.
- For Teacher’s Group Benefit Plans – in many cases they have a defined benefit called “Holistic Nutrition” coverage, which includes ROHP/RNCP nutritional counseling – provided an active IONC registration number appears on the receipt. Not all Teacher’s plans include the Holistic Nutrition defined benefit, and it varies within regions and boards of any given province. However, Teacher’s unions are very much interested in appeasing their members, and as a rule, will honor reimbursement of their members for ROHP/RNCP nutritional counseling.
- Blue Cross – patients who work in environments where Blue Cross is the underwriter (usually Police, Fire Fighters, Paramedics etc.) have coverage for ROHP/RNCP nutritional counseling. The one exception appears to be Ontario.
- Green Shield Insurance – many patients who work for companies where Green Shield is the underwriter, often have coverage for Holistic Nutrition Counseling as a defined benefit, which includes ROHP/RNCP with an active IONC registration number.
- Great West Life – some of the Great West Life benefit plans also cover Holistic Nutrition Counseling, but it varies from one plan to another.
- Manulife – as a rule Manulife benefit plans do not cover ROHP/RNCP nutritional counseling presently. This is likely to change in the future.
In general, if the patient is concerned about reimbursement, have them call their benefit plan provider before you render the service, and have them provide them with your ROHP/RNCP registration number and an explanation of the nutritional service they are seeking from you, and the health condition for which they are looking for nutrition and lifestyle advice and programming. Most plan adjudicators will do their best to accommodate the patient, usually up to at least $300 – $500. Some of the funds can be issued from the patient’s health spending accountant, or other areas of the benefit plan targeting proactive health initiatives.
Dr. James Meschino DC, MS, ROHP