aetna insurance functional medicine covered by insurance

Aetna.

Aetna partners with Index Health to provide online doctor services, supporting your journey through functional medicine.

Available for residents of: Florida, Massachusetts, New York, Pennsylvania, New Hampshire, and Virginia

Blue Cross Blue Shield logo

Blue Cross Blue Shield.

Blue Cross Blue Shield partners with Index Health to offer online doctor services as part of your functional medicine journey.

Available for residents of: Florida, Massachusetts, New York, Pennsylvania, New Hampshire, and Virginia

elevance health logo

Elevance / Anthem.

Makes online doctor visits seamless, ensuring that your health needs are met conveniently and comprehensively.

Available for residents of: Virginia.

How to confirm insurance coverage.

We accept insurance in New York, Massachusetts, Florida, New Hampshire, Virginia, and Pennsylvania, but not currently in California and Texas.

For Blue Cross Blue Shield, we accept following insurance plans:

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Preferred Provider Organization Network (PPO)

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Pathway X Tiered Hospital (HMO)

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Pathway Tiered Hospital (HMO)

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Commerical (HMO)

Please check your Deductible, Co-Insurance, Co-Pay to estimate total insurance coverage and cost.

Still not sure?

Please call the number on the back of your insurance card and provide them with the following:

NPI-Codes

Group NPI

1275243719

Ziemba Medical / Index Health

CPT-Codes

99205

99215

99417

97802

97803

Functional Medicine covered by insurance. What’s covered?

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In-Network Provider Advantage: Embrace the convenience of in-network coverage with Elevance (Anthem) in Virginia, Aetna, and Blue Cross Blue Shield PPO plans in select states.
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Simplified Claims Management: We handle Out-of-Network (OON) claims, streamlining your experience so you can focus on what matters – your health.
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Lab Work Coverage Clarity: Enjoy peace of mind with typically covered lab services from in-network providers Labcorp and Quest.
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Flexible Options for Specialist Tests: Gain control with clear choices and transparent pricing for specialty tests.
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Efficient Reimbursement System: Navigate the reimbursement process for specialty labs with ease, thanks to our straightforward super bill process.
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Financial Versatility: Make the most of your Health Savings Account (HSA) or Flexible Spending Account (FSA) to cover our monthly fee, aligning your health goals with your budget.

Insurance plans we accept.

IMPORTANT:
Not all physicians are eligible to accept every insurance plan mentioned.
Please verify on the physician's profile to confirm if they are licensed in your state and accept your preferred insurance provider.

aetna insurance functional medicine covered by insurance
Available in Florida, Massachusetts, New Hampshire, New York, Pennsylvania, and Virginia.
  • Open Choice® PPO
  • Affordable Health Choices® limited benefits insurance plan (SRC only)
  • Select℠
  • Voluntary Plans
  • HMO
  • Managed Choice® POS
  • QPOS®
  • Aetna Choice® POS II (Open Access)
  • Health Network Only℠ (Open Access)
  • Health Network Option℠ (Open Access)
  • Elect Choice® EPO (Open Access)
  • Managed Choice® POS (Open Access)
  • Aetna HealthFund® Plans
  • Premier Care Network Plus (APCN Plus)
Blue Cross Blue Shield logo
Available in Florida, Massachusetts, New Hampshire, New York, Pennsylvania, and Virginia.
  • Preferred Provider Organization Network(s) (PPO)
  • Participating Indemnity/Traditional Network(s) (PAR)
anthem logo
Available in Virgnia.
  • Virginia Commercial (HMO)
  • Pathway X Tiered Hospital (HMO)
  • Pathway Tiered Hospital (HMO)
Available in Florida, Massachusetts, New Hampshire, New York, Pennsylvania, and Virginia.
  • Standard Medicare (Not Medicare Advantage)

FAQ

Where is Index Health available?
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Currently, Index Health is available in California, Texas, Florida, Massachusetts, New Hampshire, New York, Pennsylvania, and Virginia. Stay tuned for updates on new services across the USA. 

What are the benefits of virtual care?
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Virtual care, also known as telehealth or telemedicine, offers several benefits when compared to traditional in-person healthcare. Here are some of the key advantages of virtual care:

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Accessibility and Convenience: Overcomes geographical barriers, allowing care from anywhere (you will need to be in the state that you live for your consultations). Eliminates travel time and costs.
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Flexible Scheduling: Appointments available to suit busy schedules. Reduces and even eliminates appointment wait times.
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Continuity of Care: Simplifies follow-up appointments. Supports ongoing monitoring for chronic conditions.
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Time and Cost Savings: Saves travel time & expenses. Eliminates waiting room time.
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Privacy and Confidentiality: Offers a secure environment for sensitive discussions. Enhances patient comfort.

Remember, the suitability of virtual care versus traditional care depends on the medical situation, patient preferences, and healthcare provider recommendations.

What's included when I become a member?
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We recommend following our highly rated health program that includes 5 physician visits, and 3 nutritionist visits, which has shown to deliver the best outcomes for our patients. In addition to the above, as an Index Health patient, you'll receive the following:

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A personalized plan (nutrition, lifestyle, supplements, targeted medication if need be, and a plan to get off of medication).
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Access to advanced lab tests with advanced diagnostic capabilities.
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Unlimited messaging.
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Unlimited health coach visits.
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Discounted rates for supplements.
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Curated content for your health goals.

You can schedule a free call with an Index Health Care Manager to learn more.

Do I need to physically visit a lab even though it is fully online-based?
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Yes, while Index Health operates primarily through telemedicine, certain advanced lab tests require physical sample collection. We can provide the convenience of home draw labs and home tests, ensuring a seamless experience. Our partnerships with trusted labs allow you to schedule at-home sample collections, making it easier for you to undergo the necessary advanced tests without visiting a medical facility. This approach combines the benefits of telemedicine with the accuracy of specialized lab analyses, ensuring you receive comprehensive care from the comfort of your own space.

Does Index Health accept insurance, Medicare or Medicaid?
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Yes, Index Health is now an In-Network provider for Elevance (Anthem) in Virginia, as well as Aetna and Blue Cross Blue Shield PPO plans in New York, Massachusetts, Pennsylvania, Florida, New Hampshire, and Virginia. For these plans, you can utilize your insurance benefits for medical appointments. Please note that we do not accept Medicare Advantage or Blue Supplemental Plans at this time.

We do not accept insurance in California and Texas at the moment.

For other services, we accept Out-Of-Network insurance. During your free call with an Index Health Care Manager, you can inquire about your Out-Of-Network deductible and how it applies to our services.

Lab work, which is a key part of the Index Health experience, is typically covered by your insurance and is not included in the Index Health membership fee. We collaborate with Labcorp and Quest, which are in-network labs, ensuring a smoother process for your lab service needs.

What is Out-Of-Network?
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Think of Out-Of-Network as the opposite of In-Network, for your insurance company. An Out-Of-Network provider is a provider that is not directly contracted with your insurance company.

As an Out-Of-Network provider, we are able to submit a claim with your insurance company so that you can be reimbursed a certain amount of money for the fees paid to Index Health.

The amount reimbursable depends on your insurance plan's deductible, whether your plan will reimburse you for Out-Of-Network services, and other factors. Index Health cannot guarantee reimbursement from your insurance company.

Not sure about the details of your plan? No problem! We can help for free. You can schedule a free call with an Index Health advisor so that you can find out more information about your insurance plan's coverage, and how much you’ll potentially be reimbursed.

Can I use my HSA/FSA to pay for Index Health?
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For our $299/month membership plan, you can use your HSA/FSA, as Index Health is considered a medically eligible expense.

However, for the $125/month insurance plan, HSA/FSA cannot be used. This is due to the fact that we bill your insurance directly for appointments under this plan, and there are no medical codes associated with the $125 fee that would qualify for HSA/FSA claims. For other eligible expenses outside the insurance plan, you may use your HSA/FSA.

Do I have unlimited messaging with providers between appointments?
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Yes, you do have unlimited messaging! Think of unlimited messaging as an easy and quick way to chat with your doctor and nutritionist. We typically get back to our patients within 48 hours for most inquiries.

Can I choose my doctor/nutritionist?
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For our $299/month membership plan, you are free to choose your doctor based on availability. Please discuss your preferences with your care manager during the signup process, and we will make every effort to accommodate your choice.

For those on the $125/month insurance plan, options are currently limited. Our care manager will discuss the available options with you and help schedule your first appointment.

How much do lab tests cost?
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Lab testing is essential for our root cause diagnostics but is separate from membership fees. Standard labs like Quest Diagnostics & Labcorp are often covered by insurance. Advanced labs tailored to your health goals average $86 per month per member in the first six months, with:

  • 27% spending $0-$80
  • 70% spending $80-$160
  • 3% spending over $160
What is the average spend on supplements?
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To address nutritional deficits, the average spend on supplements is $54 per month per member in the first six months, distributed as follows:

  • 60% spend $0-$50
  • 37% spend $50-$150
  • 3% spend over $150
Will I need peptides?
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Peptides may be recommended depending on your diagnosis and health goals. The average spend on peptides is about $70 per month per member in the first six months.

What's the cancellation policy?
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You may cancel anytime after your first 30 days. The initial setup fee of $279 for the first 30 days is non-refundable. If you have any questions or are looking to cancel your membership, please get in touch at:

Clear costs. Great care.

Become an Index Health member today and get a long-term partner dedicated to preventing disease and getting you to optimal health. This is Functional Medicine covered by insurance.

With Insurance.

Currently, we do not accept insurance in CA & TX.
You will be responsible for paying your copay, co-insurance, deductible, and other related payments agreed with your plan

$125/mo
Accepting following insurances:
aetna insurance functional medicine covered by insuranceBlue Cross Blue Shield logo

elevance health logo
What’s covered by insurance:
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Unlimited doctor visits (60 min).
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Unlimited nutritionist visits (60 min).
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Lab testing from LabCorp & Quest (typically).
What’s covered by the membership:
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Unlimited health coach visits.
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100% personalized treatment plan.
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Unlimited messaging.
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Access to advanced lab testing.
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Premium support.
start membership

Cancel anytime after the first 30 days.

With Insurance.

Currently, we do not accept insurance in CA & TX.
You will be responsible for paying your copay, co-insurance, deductible, and other related payments agreed with your plan

$1,250/yr
Save two months with our yearly plan!
aetna insurance functional medicine covered by insuranceBlue Cross Blue Shield logo

elevance health logo
What’s covered by insurance:
check mark blue
Unlimited doctor visits (60 min).
check mark blue
Unlimited nutritionist visits (60 min).
check mark blue
Lab testing from LabCorp & Quest (typically).
What’s covered by the membership:
check mark blue
Unlimited health coach visits.
check mark blue
100% personalized treatment plan.
check mark blue
Unlimited messaging.
check mark blue
Access to advanced lab testing.
check mark blue
Premium support.
start membership

Cancel anytime after the first 30 days.

Conditions we treat.

Get Functional Medicine covered by insurance.