Costs, Packages and Supplement Sales in Integrative Care: Financial Transparency Questions

This page is general information, not medical advice. It names no clinics, products or prices. A fee or a package never decides whether a treatment is right for you; serious or worsening symptoms need a doctor first, and in a US emergency call 911.

What we could and could not find about prices

People often search for what a naturopathic doctor or a functional medicine visit costs. Proper evidence not found for typical prices in the sources we read (NCCIH's payment guidance, the AMA ethics code and FDA and NCCIH supplement pages). Prices differ by clinic, city, visit length and what is bundled, so this page gives you questions instead of numbers.

What the sources do show is the scale of out-of-pocket spending in the US. NCCIH reports, from the 2012 National Health Interview Survey, an estimated $30.2 billion a year out of pocket on complementary health approaches, including $14.7 billion on visits to practitioners such as chiropractors, acupuncturists and massage therapists and $12.8 billion on natural products. [1] These are national totals from 2012 for a mix of practices, not a price for any one service.

Questions to ask about the visit

NCCIH suggests asking practitioners about payment before you begin. [1]

Ask for the answers in writing, including cancellation and refund terms. Written terms are our suggestion, not a requirement stated in the sources.

Insurance: ask, do not assume

NCCIH says not to assume your insurance will cover a practitioner's services, because plans differ greatly and restrictions may apply. [2] It suggests asking your insurer whether the approach is covered for your condition, whether it needs preapproval, a prescription or a referral, whether you must use a network practitioner, and what limits apply. [1] In its 2012 data analysis, coverage for acupuncture, chiropractic and massage was more likely to be partial than full. [1] We did not read comparable data for naturopathic visits or lab tests, so check each item, including laboratory fees, with your insurer. NCCIH adds that keeping records of calls, bills and claims may help if you have a dispute. [1]

Tests and lab fees

A visit fee may not include laboratory work. Ask which tests are proposed, who bills for them, and whether your own doctor already ordered them. The claims behind specialty tests are covered on tests sold in integrative practice and over-testing and false positives.

Prepaid packages

Some clinics offer programs paid up front. Proper evidence not found in the sources we read on how common they are or what rules apply, so we cannot say. Practical questions: what exactly is included, what happens if you stop or your health changes, and can you pay visit by visit instead? Pressure to commit quickly is a warning sign discussed on red flags in integrative marketing.

Supplements sold in the office

Some practitioners dispense supplements. That can be convenient, but it creates a financial interest in what they recommend.

The American Medical Association's ethics opinion for physicians says that selling health-related products raises concerns about financial conflict of interest and may put undue pressure on the patient. [3] It says physicians who sell should offer only products whose claims rest on unbiased, reliable scientific review, and should fully disclose their financial interest and tell patients that equivalent products may be available elsewhere. [3] That opinion applies to physicians. Whether other professions follow similar written rules is not described in the sources we read, so ask any practitioner about their own policy.

Quality is a separate question. Under US law the FDA is not authorized to approve dietary supplements for safety and effectiveness before they are marketed. [4] NCCIH notes that what is on the label may not be what is in the product, and a manufacturer using the word "standardized" does not necessarily guarantee quality. [5] Questions worth asking: Why this product for me? What does the evidence say? Do you earn money if I buy it? Can I buy an equivalent elsewhere? Is the price different from other sellers? More on this is on supplements dispensed in integrative practice and comparing supplement labels and cost per serving.

Tax-advantaged accounts

NCCIH notes that flexible spending arrangements and health savings accounts may help cover some complementary health approaches. [1] Rules vary by plan, so ask your plan administrator.

Keep care coordinated

Cost can tempt people to skip medical visits. Tell your doctor what you are paying for and taking. See coordinating complementary and medical care and questions to ask before you commit.