Why Balanced Living Functional Medicine DOES NOT take Insurance
We get a lot of questions from people considering functional medicine. One of the most common questions we get is: Why don’t you take insurance?
It’s a fair question! Paying out of pocket for healthcare can feel unfamiliar, especially when most traditional medical practices work within the insurance system. But like many other functional medicine practices, we made this decision with one priority in mind – our patients’ best outcomes.
In this post, we’ll break down why we don’t participate with insurance and how this choice ultimately benefits our patient’s health and healing journey, allowing us to keep doing what we do best!
The Insurance company should not decide your treatment
When a practice takes insurance, it is the insurance company deciding which services are covered. They dictate what medications (if needed) the patient can or can’t have as well as what tests will be covered with little regard for what the doctor is recommending.
These companies favor conventional treatments – like medication and procedures – while placing little emphasis on preventive care and wellness. We prefer to focus on:
Education to empower clients to make the best choices for themselves
Support in creating a healthy lifestyle which reduces symptoms in general by half!
Addressing the root cause(s) of the client’s condition rather than simply diagnosing and prescribing medication (which is often the default in insurance-driven care)
Focus on preventative care as well - this doesn’t mean getting your routine mammogram to see if you have cancer but helping you prevent ever getting cancer in the first place!!!!
Creating health, not just avoiding illness
Appointment Length & Fee Structure
Insurance companies set reimbursement rates based on high patient volume and short appointment times, leaving doctors with only a few minutes per visit. As a primary care physician, I typically saw 20-30+ patients per day, rushing from one to the next. There was not enough time to fully connect and understand what that patient truly needed.
Now, I see 4-6 patients daily, dedicating 90-120 minutes to new patient visits and up to 60 minutes for follow-ups. This gives us the time needed to dive deep into each patient’s concerns as well as spend a lot of time educating on the principles of functional medicine and health creation. The goal here is to empower the client to feel capable and ready to heal - not something you’ll get from the insurance companies.
I get to know my clients on a whole new level, listen fully to their story and have the time to really understand their health goals. Most of our clients say this is the first time they ever felt truly listened to by their doctor or care team!
If we operated within the insurance system, it would be impossible to provide this level of attention and personalized care. Insurance models encourage doctors to maximize the number of patients they see per day – benefiting the insurance companies, more than the doctor OR the patient!
By cutting out the middleman, every dollar you invest goes directly into supporting our team and improving your care, not padding an insurance company’s bottom line. This allows us to provide the best care possible, free from the constraints of rushed, insurance-driven medicine.
What we prioritize instead:
Mindful Testing
For our members, all functional lab tests are offered at wholesale prices –you pay what it costs us to run them, no markups. Additionally, we can attempt to bill many standard bloodwork orders through traditional insurance if our client would like or they can be purchased through a direct pay lab at a fraction of the cost that insurance charges.
We also take a mindful approach to lab testing. Instead of ordering excessive tests that drive up costs, we individualize our test orders to each patient.
HSA/FSA Payments
We happily accept HSA/FSA cards and provide documentation to help with reimbursement. Many of our clients are glad to have this option to pay for high level care with tax free money.
Price Transparency
Receiving traditional care that’s reimbursed through insurance can be unpredictable. It can be unclear how much of certain services will be covered until you receive a bill, sometimes much later than the date of service. When paying for our services, it’s clear and straightforward, with a predictable monthly cost. We are always here to clarify and answer questions.
Added Benefits and Community
If you choose to work with Balanced Living, you will become a member of our practice. With this investment comes what you might expect - appointments with your care providers - but it also comes with a whole host of other benefits not offered by offices that take insurance. These include:
A library of recorded educational videos made by myself and my team on all sorts of topics such as leaky gut, autoimmunity, inflammation, hormonal balance, detoxification, stress management and so much more
An invitation to our live webinars and community support meetings, each happening monthly
A discount on pharmaceutical-grade supplements
Resources such as meal plans, recipes, handouts and more
While paying out of pocket can come with a higher upfront investment, the quality of care and depth of support it allows are unmatched. Without the restrictions of insurance, we can focus on real, lasting transformations – spending more time with each patient, personalizing care, and addressing root causes rather than just symptoms.
This freedom ultimately leads to better results in less time, empowering our clients to take control of their health in a way that truly lasts. And lasting health is worth every cent!
In health,
Dr. Emily