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Before Your First Session

Designed For Health LLC is currently in-network with BlueCross BlueShield (BCBS) and UnitedHealthcare (UHC). We highly recommend verifying your nutrition counseling benefits before your first session, as coverage varies by plan and may include specific requirements, limitations, or exceptions.

The following guidance is based on our experience but does not guarantee coverage.

BlueCross BlueShield (BCBS)

Many BCBS PPO plans cover nutrition visits at 100%—no deductible, no co-pay, and no visit limit. However, labor union and out-of-state BCBS plans often exclude preventive nutrition services unless a medical diagnosis (e.g., obesity, diabetes, CKD) is present.

If your plan requires a diagnosis, contact your primary care provider for a referral that includes your BMI or medical diagnosis, and submit it before your first session.

UnitedHealthcare (UHC)

Most UHC plans cover 100% of visits if you have:

  • A BMI of 30+, or

  • A BMI of 25+ with a cardiovascular or diabetes-related diagnosis

Some plans may cover BMI 25–29.9 without a diagnosis, but this depends on your specific policy. UMR plans, a UHC subsidiary, typically do not cover nutrition visits in our experience. Contact UHC directly to confirm your plan’s eligibility.

If a diagnosis is needed, a physician referral is required before your first session.

Important Payment Information

If using insurance:

  • Claims will be submitted on your behalf.

  • If insurance does not cover the session, or if there is a co-pay, you will be invoiced.

  • Payment is due within 30 days of notice. Accepted methods: HSA/FSA, credit/debit cards.

  • You are responsible for any fees not covered by insurance.

If out-of-network, we can provide a superbill upon request. You may submit it to your insurance for reimbursement, but coverage is not guaranteed, and full session fees remain your responsibility.

Questions to Ask Your Insurance Provider

Before booking, please call your insurance company and ask the following:

  1. Is nutrition counseling or medical nutrition therapy covered?

    • Ask if these CPT codes are covered: 97802 (initial), 97803 (follow-up).

    • If not, ask about: 99401–99404.

    • Ask if the ICD-10 code Z71.3 is covered. If not, ask which diagnoses are.

  2. Is a referral or specific diagnosis required for coverage?

    • If yes, request a referral from your provider with appropriate ICD-10 codes and fax it to us at 630-597-1147 before your first visit.

  3. Are Telehealth visits covered?

    • Many plans cover Telehealth for preventive services. Confirm with your provider.

  4. How many sessions are covered per year?

    • Ask if there's a limit on visits or units.

  5. Is there a deductible that must be met?

    • Preventive services are often exempt, but not always.

  6. Is there a co-pay for nutrition visits?

    • Some plans require a co-pay, especially if dietitians are classified as specialists.

  7. Always request a reference number for your call.

    • This serves as documentation in case coverage is later denied.

For further help verifying your benefits or submitting paperwork, Designed For Health LLC is here to support you. We’ll also advocate on your behalf in the event of denied claims.