05/06/2026
I see a lot of people on our forums asking all the time for a good functional medicine doctor that takes insurance, and I also see an awful lot of people asking why all these doctors who diagnose difficult conditions only take cash. This falls in the nature of a dilemma that is not answered by conventional medicine. In order to diagnose some of these more difficult conditions it takes a lot of extra training, a lot of time and a lot of very difficult to come by experience. It leans directly into the question between insurance care and personal care.
Many people are searching for a doctor who will:
• listen carefully
• spend real time with them
• look for root causes
• explain things thoroughly
• provide functional or holistic approaches
• and still “take insurance.”
None of these are unreasonable things to look for, however, the problem is that modern insurance systems were not designed around that kind of medicine.
Insurance reimbursement is largely built around volume, speed, and standardized treatment models. In many offices, doctors are forced to see patient after patient in very short time slots just to keep the doors open. That often creates an assembly-line style of healthcare — brief visits, limited conversation, and symptom management instead of deep investigation. Medicare, for example, has not changed its reimbursement schedule since 2008 and many doctors simply will not take it, not to mention the fact that it doesn’t reimburse for many of the diagnostic procedures or conditions that patients need diagnosed or treated. Some doctors will do this but cannot do this in just a few minutes.
True personalized medicine takes time. As a matter of fact, in my office a true functional medicine evaluation takes an hour and a half. Shop Time, as any business owner will know, covers the operating costs of your office for one hour. Anything less than that loses money and costs your staff their jobs. Simply taking what insurance reimburses for this kind of work is a path to being homeless. In order to do this kind of work you have to charge cash. In my office this initial evaluation is $450 without any additional testing. Additional testing can encompass imaging ranging from X rays to MRIs including digital motion X-ray which can range from $250 all the way to $2500. Functional blood work can range from $450 to well over $2000. Allergy testing, especially functional allergy testing can be much more. Many of the standard tests done by modern medicine do not cover the kind of testing that is necessary in some cases. As a matter of fact, we often call the blood work done in a standard office the ‘malpractice panel:’ Just enough blood work to not get sued but not really tell you anything other than you’re not dying right now.
Functional medicine, nutrition-focused care, lifestyle counseling, detailed history-taking, advanced testing review, and individualized treatment planning can require long appointments, ongoing communication, research, and careful follow-up. Unfortunately, much of that work is either poorly reimbursed by insurance… or not covered at all.
There’s an old business principle often shown as a Venn diagram:
You can usually choose two:
• Fast
• Cheap
• High Quality
But getting all three at the same time is impossible.
Healthcare is no different.
Patients understandably want affordable care covered by insurance. Doctors want to help people thoroughly and ethically. But the current system often rewards speed over depth.
That does not mean insurance-based doctors do not care. Many care deeply. They are simply operating inside a system with significant time and reimbursement limitations. However, this often limits their choice of testing because they will only tell you about the test that insurance reimburses. Many things get missed because they cannot use the right tests.
And it does not mean personalized functional medicine is “expensive for no reason.” Often, what patients are paying for is something increasingly rare in modern healthcare:
time, attention, investigation, education, and individualized care.
The right answer for each patient is different. But understanding the difference between “covered care” and “comprehensive care” helps people make more informed decisions about their health. Usually, the doctor that you really need is not the one on your insurance plan
Your health is most important to you, and your responsibility. It is useless to get mad at a doctor using insurance whenever don’t take care of yourself. I have seen patients buy big screen TV’s take extravagant vacations and not be willing to spend a penny for their health.
Whose Fault is that?
Certainly not the Doctor.
If you want good health care, you really need to be able to take responsibility for yourself and find the kind of doctor who will take the time to listen and if they take your insurance that is a bonus, but you will likely have to step out of that system to get real answers.
And sometimes the most valuable part of healthcare is having someone truly take the time to listen And do what is right regardless of what the insurance company tells them to do.
