Herbal Supplements

For Members

• What are Herbal Supplements?
  • Herbal supplements are products derived from plants and/or their oils, roots, seeds, berries or flowers. Herbal supplements have been used for many centuries.
  • If you are considering using an herbal supplement, please be aware that many herbal supplements may interact with both prescription and nonprescription medications and can cause some very serious interactions and adverse effects.
  • If you have allergies, especially allergies to plants, weeds, or pollen, you should consult your primary health care provider before taking herbal supplements. Patients taking blood thinners should always consult their primary health care provider before using any of the herbal supplements/medications.
  • Remember, “natural” does not always mean safe and free of adverse effects. When it comes to your health, always discuss with your treating physician when in doubt.

• Insurance coverage of Herbal Supplements/Medications:
  • Herbal medicines are covered by Nextcare only if mentioned/covered explicitly in the table of benefits, except for a specific list which is covered based on the medical necessity.

For Healthcare Providers

• All types of herbal preparations require Pre-Authorization from Nextcare.
• In case of rejection, the reasons for herbal supplements/medicines will be:
  • M009: Prescribed medicines not covered as per policy
  • NCOV-003: Service(s) is (are) not covered
  • NCOV-027: Non Coverage of certain medication as per policy