Does Blue Cross Blue Shield Cover Naturopathic Doctors? By State

Whether Blue Cross Blue Shield covers naturopathic doctors depends on the state your plan is issued in, the specific BCBS company and plan type, and what service you’re seeing the naturopath for. In some states, a BCBS plan pays for an ND office visit on the same terms as any primary care visit. In others, the same company classifies naturopathy as experimental and excludes it entirely. The only binding answer comes from your own plan documents or the member services number on your card.

Why the Answer Depends on Your State

Blue Cross Blue Shield is not a single insurer. It’s an association of independent, locally operated companies, each writing its own medical policies and plan designs.¹ Two state-level factors shape what any given BCBS plan will do with a naturopathic claim.

The first is licensing. As of 2025, 26 U.S. jurisdictions license or register naturopathic physicians, including 23 states plus the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.² Licensed states include Arizona, California, Colorado, Connecticut, Hawaii, Maine, Maryland, Massachusetts, Montana, New Hampshire, Oregon, Vermont, and Washington, among others.³ If your state doesn’t license NDs, there’s no recognized credential for a BCBS plan to reimburse, and coverage is essentially unavailable.

The second is state insurance law. Five states have provider non-discrimination laws that protect naturopathic physicians specifically: Vermont, Alaska, Washington, Connecticut, and Montana.⁴⁵ These generally require insurers to treat licensed NDs comparably to other licensed providers for services within their scope of practice.

At the federal level, ACA Section 2706 says group plans and individual insurers “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.”⁶ Enforcement has been weak. Federal agencies withdrew initial guidance in 2015, and plans are expected to use a “good faith, reasonable interpretation” while no final regulations exist. The provision also doesn’t force plans to accept any willing provider or admit all provider types into a network.⁷

States Where BCBS Is Most Likely to Cover a Naturopathic Visit

Vermont

Vermont law (8 V.S.A. § 4088d) requires health insurance plans to cover medically necessary services provided by a licensed naturopathic physician when those services fall within the ND’s lawful scope. Plans must recognize NDs who practice primary care as primary care providers and apply cost-sharing that is no more restrictive than for other primary care physicians. The mandate covers Medicaid, individual and group plans, and HMO contracts.⁸ Most Vermont plans still exclude naturopathy-specific services such as acupuncture, allergy neutralization treatments, nutritional supplements, herbal formulas, and homeopathic remedies.⁹

Washington

Washington has an “every category of provider” mandate covering all state-licensed provider types. Premera Blue Cross, a BCBS licensee in the state, offers a naturopathic benefit on select Medicare Advantage plans (Classic HMO and Total Health HMO) that covers up to six visits per year at a $30 copay, no referral required. Covered services include office visits, telehealth, infrared modality, manual therapy, and urinalysis. Herbs, homeopathic remedies, medications, nutritional supplements, vitamins, and vitamin injections are excluded, and an ND cannot be assigned as a member’s primary care provider under these plans.¹⁰

Montana

Montana Code 33-30-1017 requires health service corporations to cover services from a licensed naturopathic physician if those services are otherwise covered by the contract.¹¹ A Montana University System employee plan, for instance, covers naturopathic office visits as primary care at a $25 copay, with homeopathic services excluded and some risk of balance billing.¹² Montana naturopathic practices report being in-network with BCBS of Montana, though specific plans can still exclude the benefit.¹³

Oregon

Oregon licenses NDs and has a non-discrimination law. Naturopathic practices in the state report being in-network with Regence BlueCross BlueShield and related BCBS plans.¹⁴¹⁵

Alaska

Alaska licenses naturopathic physicians and has an insurance equality law (AS 21.36.090). Federal Blue Cross Blue Shield covers naturopathic care, including massage services, at preferred providers in Alaska. Medicare, Medicaid, and several other federal programs do not.¹⁶

Arizona

Arizona licenses NDs and recognizes them as primary care providers. BCBS of Arizona may reimburse naturopathic visits, but NDs are frequently categorized as out-of-network even in the state. Patients often pay out-of-network rates upfront and submit claims for reimbursement, and pre-authorization may be required depending on the plan.¹⁷

States Where BCBS Typically Does Not Cover Naturopathy

Several BCBS affiliates explicitly classify naturopathic medicine as experimental or investigational, which functions as an exclusion.

Blue Cross Blue Shield of Tennessee considers naturopathy and other complementary and alternative medicine “investigational” for the diagnosis, prevention, or treatment of disease, finding that these therapies don’t meet the plan’s Technology Evaluation Center criteria. The medical policy isn’t the final word on any member’s benefits, and members are directed to check their specific plan.¹⁸

Blue Cross Blue Shield of Michigan and Blue Care Network classify complementary and alternative therapies unsupported by valid scientific studies as “experimental/investigational” and not a covered benefit. Their policy defines naturopathy as a system that “rejects the use of medication(s) and is based on the theory that diseases can be successfully treated or prevented through diet, exercise and massage.”¹⁹

Blue Cross and Blue Shield of Kansas lists naturopathy as “alternative medicine” without indicating it is a covered benefit.²⁰ Blue Cross Blue Shield of Massachusetts doesn’t appear to cover naturopathic visits as a standard benefit but runs a Living Healthy Naturally discount program offering up to 30% off network alternative practitioners, including NDs, in all 50 states. That’s a discount members pay directly, not insurance coverage.²¹

What’s Covered and What’s Excluded When BCBS Does Pay

Even in states with mandates, the covered portion is narrower than many patients expect. Office visits and standard diagnostic lab work ordered by an ND are the services most likely to be reimbursed. Supplements, herbal medicines, homeopathic remedies, vitamins, vitamin injections, and specialty functional medicine tests are almost always excluded across plans that offer any naturopathic benefit.¹⁰⁹ Claims also fare better when care targets a specific documented condition with a diagnosis code, rather than general wellness.

PPO plans are more likely to cover naturopathic visits, sometimes at an out-of-network rate. HMO plans rarely do.⁴

Medicare and Medicaid

Original Medicare does not cover naturopathic services nationally, and most state Medicaid programs also exclude them. Vermont’s mandate is a notable exception, extending to Medicaid.⁸ Some Medicare Advantage plans, such as Premera Blue Cross’s in Washington, include naturopathic care as a supplemental benefit beyond what original Medicare offers.²²

How to Check Your Own Plan

Log into your member portal. BCBS describes this as “the most reliable way to see everything that is available to you.” You can find your local BCBS company through the Find My Plan tool at bcbs.com using your ZIP code or the first three characters of your member ID.¹
Call member services and ask specifically whether your plan covers visits to a licensed naturopathic doctor. If your state recognizes NDs as primary care providers, say so, since it can affect how the claim is processed.¹⁷
Ask about in-network ND providers, visit limits, copay amounts, and whether pre-authorization is required.
Request written confirmation. Verbal assurances from a phone representative aren’t binding.
If your ND is out-of-network, ask for a superbill. It’s an itemized receipt with the provider’s NPI, CPT service codes, and ICD-10 diagnosis codes, and it lets you submit a claim for potential reimbursement.⁴

What You’ll Pay If Coverage Doesn’t Apply

Initial naturopathic consultations typically run $150 to $400, with some clinics in high-cost areas charging up to $750. Follow-ups usually fall between $100 and $200. Lab work adds on: basic blood panels $50 to $300, hormone testing $150 to $400 or more, gut health tests $250 to $500 or more. Supplements run $20 to $200 a month, and IV therapies cost $75 to $300 per session.²³

Paying With an HSA or FSA, or Deducting on Your Taxes

IRS Publication 502 defines deductible medical expenses as the costs of “diagnosis, cure, mitigation, treatment, or prevention of disease” and includes payments for “legal medical services rendered by physicians, surgeons, dentists, and other medical practitioners.”²⁴ Naturopathic doctors aren’t named specifically, but fees paid to a licensed ND treating a diagnosed condition can fall under “other medical practitioners.” Care has to be primarily to alleviate or prevent an illness, not for general health improvement. Vitamins and supplements for general wellness don’t qualify.

HSA and FSA rules follow the same principle, though FSA reimbursement is governed by the plan’s own terms rather than the tax-year payment rule that applies to the deduction. Some employer FSA or HRA plans add further restrictions, and a letter of medical necessity from your ND can help with reimbursement.²⁴

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