Will My Insurance Cover Collagen Protein Medical Nutrition?

By: - October 5, 2020

 

If you’re taking collagen protein for medical purposes – such as healing a surgical wound or treating malnutrition – you may wonder whether or not your insurance will cover the cost. 

We understand that the price of any daily supplement can start to add up quickly.

So, we wanted to explore if taking collagen supplements is something that might be covered by your medical insurance.

Before we dive in, it’s important to know that there are a lot of factors that go into whether your insurance will cover collagen protein as medical nutrition or not.

One of the best ways to find out is to call your insurance company directly. You can also consult your medical practitioner.

If your doctor is already prescribing you collagen protein for medical purposes, they should be able to determine if your collagen protein is covered. 

Still, the answer is never cut and dry when it comes to medical nutrition and insurance coverage. So we’re going to evaluate the primary factors that may determine whether your ProT Gold is covered or not.

What defines medical nutrition?

Medical nutrition therapy is most often defined as the application of Nutritional Care in a clinical setting with a focus on disease management and treatment.

This nutrition therapy is carried out by a dietitian or nutritionist. 

 

You’ve likely heard of a dietitian or nutritionist. Medical professionals in the fields of diet and nutrition are the people you should go to for medical nutrition therapy. 

Patients of medical nutrition therapy will undergo individualized and very detailed nutrition assessments during preliminary appointments with their nutritionist. And, they will continue evaluations and counseling as their disease diagnosis changes. 

Although the idea of promoting better health through nutrition has been around for a very long time, using nutrition and diet – especially collagen peptide protein – as a medical treatment is a relatively new practice in western medicine.

The medical benefits of nutrition shouldn’t be surprising though. What you eat directly impacts the way your body functions.

Medical nutrition therapy is sometimes called clinical nutrition, and it is most well known as a treatment for type 2 diabetes. However, it has numerous other applications, especially in regards to collagen protein. 

That also means it is now easier for insurance companies to cover appointments with dietitians, nutritionists, and other holistic medicine professionals. 

How do I know if collagen protein is covered by my insurance?

The first step to finding out if your insurance covers collagen protein is to see if medical nutrition therapy is covered. For most insurance companies, if your medical doctor refers you to a dietitian or nutritionist, the visits will be covered. 

However, not all of the prescribed supplements or medications will always be covered. 

Most of these variations are dependent on the type of insurance and the provider that you have. 

One of the biggest hurdles that patients come across when trying to get insurance to cover collagen protein is actually where the medical nutrition is consumed or applied.   

In some cases, insurance only covers collagen protein if it is prescribed and consumed in liquid form – in a hospital. These restrictions could make it difficult for patients to get coverage when using the medical nutrition supplement.

Luckily, the legislation was under review in 2019 to allow medical nutrition to be covered by insurance both in – and out – of a hospital setting. 

If this legislation were to pass, it would ensure that all insurance providers would allow for liquid medical supplements, like collagen protein, to be covered by insurance and used as needed by patients. 

Beyond the location specifications that some policies require, a more common reason why medical nutrition therapy would (or would not) be covered by insurance is the reason for treatment. 

Yes, you can be denied insurance coverage if you don’t have the right disease. 

Some insurance plans only cover specific health conditions like diabetes, high cholesterol, and obesity. This means that, even if your insurance covers medical nutrition therapy, you might only receive coverage under their specified list of health conditions or diseases. 

And, you could also have a plan that strictly covers medical nutrition counseling, but none of the prescribed supplements. 

These are just a few examples of the many reasons most people glaze over medical nutrition therapy as a viable treatment option. It can be extensively confusing to know if your insurance will cover it. 

*Note: Insurance coverage for collagen protein for medical nutrition purposes is different from collagen for cosmetic surgeries or injections. These various applications of collagen may not be covered by insurance. Do note that both may not be covered, and be sure to read the fine print or call to ask about coverage regarding collagen protein.  

What questions should I ask my insurance provider to learn more?

Navigating your insurance plan to learn if your medical nutrition therapy treatments are covered can be confusing. But it’s a lot easier if you know the right questions to ask.

Some of the questions you should ask your insurance provider include: 

  1. Does my insurance require a referral from a doctor for medical nutrition coverage?
  2. Are there other referral options?
  3. Does my insurance offer preventative service coverage like screening or counseling?
  4. Does my insurance only cover specific conditions? If so, what are the conditions included?
  5. Does my insurance exclude any diagnoses or medical conditions from nutritional benefit and coverage?
  6. Does my insurance only cover the appointment or counseling session for medical nutrition therapy? If so, do I have unlimited visits each year, or is there a specific number of covered appointments?
  7. What types of supplements or medications does my insurance cover? 
  8. Is there a copayment required to see a registered dietitian or a nutritionist? If so, how much do I need to pay out of pocket for each appointment?

Your doctor or dietitian may be able to help you navigate some of these questions, but in most cases, you will need to call your insurance provider to get detailed information.

When asking your insurance provider about medical nutrition therapy, be sure that you are specific about your needs, and ask them targeted questions. 

For instance, if you know that your insurance covers the medical nutrition therapy appointments, but aren’t sure about supplement coverage, specifically ask the insurance provider if liquid collagen protein is covered when prescribed by your doctor.

This gives them a tangible item and concise question, making it easier for them to answer. 

Other issues with medical nutrition and insurance

Knowing what your insurance provider covers is one thing, but finding a dietitian that accepts that insurance is another. 

Owning a private medical nutrition therapy practice, and accepting insurance instead of patient self-pay, requires extra credentialing that can take months.

This might be worth it for some dietitians and their patients. But, since most insurance providers do not have streamlined coverage options, credentials for all of them are incredibly time-consuming.

Which insurance providers have the best options for medical nutrition therapy?

Each insurance provider has its own set of rules regarding coverage options. So, if you know you need medical nutrition therapy – and could be prescribed supplements like liquid collagen protein – it helps to know your options. 

Let’s look into some of the most commonly used insurance options, and their coverage when it comes to medical nutrition therapy. 

MNT = medical nutrition therapy

RDN = registered dietician nutritionist

Medicare MNT

Medicare is a very niche medical insurance provider that only provides coverage to patients 65+ (or those under 65 if they have a disability of some kind). The insurance payments are typically low or no-cost and the insurance is granted without regard to your income. 

MNT is covered by Medicare within specified limits.

For instance, MNT is only included for patients diagnosed with diabetes, non-dialysis kidney disease, and for 36 months post kidney transplants. And, these medical conditions are only covered if a physician referred the patients.

The RDN also needs to have credentials to provide consultation to a Medicare recipient and be enrolled as a Medicare Provider. 

During the initial year of your medical referral of MNT with an RDN, Medicare will cover three hours of MNT and two hours each subsequent year. In most cases, hours cannot be carried from year to year. 

Whether or not your insurance will cover collagen protein as a part of your medical nutrition therapy is dependent on the Medicare plan you have. In most cases, vitamins and supplements are not a part of your insurance plan with Medicare. However, if you have a Medicare plan A or B, you could qualify for Medigap

Medigap is a branch of Medicare designed to fill the “gaps” in medical insurance coverage. This may include collagen protein supplements. 

BlueCross BlueShield MNT

Your BlueCross BlueShield insurance plans may cover medical nutrition therapy or counseling, but you will need to contact your provider for specific coverage information. In most cases, supplements will not be included (or even prescribed) for MNT if you go to an RDN credentialed under BlueCross BlueShield. 

Your RND will likely only prescribe collagen protein if you have a specific injury or medical condition that would benefit directly from its use. In these special scenarios, you wouldn’t be using the collagen protein supplement long term, but as a way to recover and move through your treatments. 

The BlueCross BlueShield website for each state also has a differentiation between what is covered under each plan for MNT.

We cannot provide a very decisive or detailed guide here because each state’s coverage is different. 

Medicaid and RDN

Medicaid is often confused with Medicare, but they are very different programs. Medicaid is a state and federal medical insurance program that provides primary insurance plans to low-income individuals or families. 

Each state may have varying degrees of coverage, but for the most part, under the Affordable Care Act, preventative care services like MNT were included with Medicaid health insurance coverage.

As with other medical insurance coverage, it depends on your policy, and there are restrictions. 

The two ways you can receive MNT through Medicaid are: dietary counseling for adults at high risk for chronic disease – or – an obesity screening. This means that an initial assessment will be covered, but appointments after that likely will not be. 

This also doesn’t usually include supplements, unless it is for a feeding tube or if the supplement is deemed medically necessary due to excessive malnutrition and weight loss. Since liquid collagen protein is sometimes used to treat malnutrition, depending on the circumstances, it may be covered.

Find out if collagen protein is covered by your insurance

While ProT Gold liquid collagen is trusted by medical facilities and practitioners all around the US and has been shown to reduce recovery times after surgery, we can’t answer if it will be covered by your specific insurance plan.

The best advice we can give you when figuring out if collagen protein is covered is to know which questions to ask your insurance provider. 

There are so many nuances and variables for each insurance provider and even each individual state. So, before you book your first medical nutrition therapy session, find out if it is covered by insurance. If it is, call your insurance provider and ask targeted questions about prescribed collagen protein coverage.

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