Ruby Oak Nutrition have been in-network dietitians with Blue Cross and Blue Shield of North Carolina since 2022. That means our entire team of dietitians accepts BCBS, making nutrition counseling more accessible to people in Raleigh and across North Carolina, and in all of the other states that we serve. (That list of states is here.)

At the beginning, deciding whether to accept insurance was a big internal conversation at our practice. We know insurance can be confusing and frustrating, and we also know many people wonder why some dietitians accept insurance while others don’t. We want to be transparent about why this matters to us and why being in-network BCBS dietitians is a meaningful part of our work.

Blue Cross Blue Shield of North Carolina has strong nutrition counseling coverage.

In many parts of the country, it’s genuinely difficult for small private practices to be in-network providers. Reimbursement rates can be very low, especially in states with a high cost of living, which makes it hard for providers to sustainably offer long-term care. That’s one major reason many dietitians and other healthcare providers choose to remain out of network.

Another barrier is coverage itself. Some insurance plans only cover a small number of visits per year or only cover nutrition counseling for specific diagnoses like diabetes or kidney disease. That model doesn’t work well for the kind of care we provide. Most of our clients benefit from consistent, ongoing support over time, not just a handful of appointments.

Here in North Carolina, many BCBS NC plans offer robust coverage for nutrition counseling. In many cases, nutrition counseling is considered preventative care, which means:

• A specific diagnosis may not be required
• 30 visits per year are covered
• Many clients pay little to nothing out of pocket

That’s a huge benefit for the people we work with.

Using insurance can make nutrition counseling more effective

When nutrition counseling is covered by insurance, it takes away some of the pressure that patients might feel to make huge changes right away. Because most of our BCBS NC patients have full coverage for 30 visits per year, they know that they’ll be able to work regularly with a dietitian without worrying about the cost. That means, they’re able to make smaller but more sustainable changes that actually make a huge impact on their health in the long term.

Change around food, body image, and health behaviors takes time. Clients who’ve been struggling for years don’t benefit from rushing through a few sessions and hoping for the best. When insurance helps cover the cost, we’re able to move at a pace that actually supports lasting change.

That means:

• Spending time understanding the full context of someone’s lifestyle, preferences, eating habits, family dynamics, time constraints, health goals, and so much more
• Addressing underlying patterns, not just surface-level behaviors
• Supporting long-term health rather than short-term “fixes”

BCBS NC’s excellent coverage for nutrition counseling makes this kind of care accessible to more people. That’s a great thing for our patients. (And, it’s even good for BCBS, because the work we do with patients actually lowers their overall healthcare costs by reducing the risk of chronic diseases and major health events or complications.)

Accepting insurance increases access and equity

One of our core values at Ruby Oak Nutrition is accessibility. Accepting BCBS allows us to work with people who might not otherwise be able to afford nutrition counseling, especially longer-term care for things like eating disorders and chronic disease.

Because many BCBS plans in North Carolina cover nutrition counseling as preventative care, clients are often able to:

• Attend sessions regularly
• Stay in our care until they’ve made meaningful changes and feel more confident about food and their health
• Receive support for eating disorders, disordered eating, GI conditions, diabetes, PCOS, and more without financial strain

This is especially important for eating disorder recovery and chronic conditions, where consistency matters.

Insurance coverage can extend beyond North Carolina

While we see clients in person in Raleigh, Ruby Oak Nutrition also offers virtual nutrition counseling across multiple states. Most BCBS plans work across state lines, which means clients with out-of-state BCBS coverage may still be in network with our dietitians, depending on where they’re located and where we’re licensed to practice.

The tradeoffs: more admin and occasional confusion

Of course, accepting insurance isn’t perfect.

For clients, it usually means calling their insurance company to confirm benefits before getting started. Coverage can vary by plan, and benefits are ultimately determined by the insurer.

On our end, insurance requires more administrative work, from submitting claims correctly to maintaining detailed documentation. Insurance companies can also request clinical notes, and policies can change over time.

Occasionally, clients are given incorrect information by an insurance representative, which can lead to unexpected bills. This is rare, but it’s why we strongly encourage clients to get a reference number whenever they speak with their insurance company.

Despite these challenges, we believe the benefits far outweigh the downsides.

Overall, we see this as a win

Accepting BCBS allows Ruby Oak Nutrition to provide high-quality, anti-diet, weight-inclusive nutrition care to more people, with fewer financial barriers. It supports longer-term work, increases access, and helps make evidence-based nutrition counseling a realistic option for more individuals and families.

We’ve also seen a significant increase in people reaching out for care since becoming in-network, which tells us there’s real demand for nutrition counseling that’s both accessible and aligned with a non-diet approach.

If you’d like to learn more about working with a dietitian at Ruby Oak Nutrition or request an appointment, you can do that here.

If you’re struggling with an eating disorder or disordered eating, we can help! We’re a group of dietitians who take a non-diet, body-positive, identity-affirming approach to recovery and healing your relationship with food. Go here to learn more about nutrition counseling for kids, teenagers, and adults, in-network with most major insurance companies and offered virtually to clients in North Carolina and over a dozen other states.

Ready to book an appointment? Click here to book online.
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