If you’ve ever looked into functional medicine and wondered, “Is this really worth it?”—you’re not alone.
It’s true: functional medicine often comes with a higher upfront cost than conventional care, especially because much of it isn’t covered by insurance. At first glance, that can feel like a big barrier, especially when you’re already navigating symptoms, burnout, and a healthcare system that often feels more reactive than supportive.
But what’s often missing from that conversation is the cost of staying sick: physically, emotionally, and yes, financially.
Because while conventional care may cover medications, labs, and 10-minute doctor visits, many people with chronic conditions spend years cycling through specialists, prescriptions, and tests that never quite get to the root cause. They’re spending money, but they’re also spending time, energy, and sometimes entire chapters of their life waiting to feel like themselves again.
What if we looked at this from a different angle?
In this article, we’re going to explore what functional medicine actually costs because you do deserve to understand what you’re really paying for. However, we’ll also take a closer look at what chronic illness can cost when left unresolved, and how those costs increase as certain conditions progress. Through real-world examples, you’ll be able to see both sides clearly and make an informed decision about your next step. Because at the end of the day most would likely agree that this type of decision isn’t just about price tags. It’s about investing in your health, your time, and your future.
The Actual Cost of Chronic Illness
When we think about the cost of chronic illness, it’s easy to picture a few extra doctor visits, some lab work, or a monthly prescription.
But the reality is that chronic disease rarely comes with a one-time bill, but instead, with a ripple effect of ongoing expenses. Costs that quietly pile up month after month, year after year. Medications, specialist visits, time off work, lost productivity, complications that require more interventions… and sometimes, the ability to work at all.
In many cases, the longer a condition goes unmanaged, the more expensive it becomes - financially, physically, and emotionally.
Let’s walk through a few real-life examples of common chronic conditions that clearly illustrate how these costs can add up over time.
Example 1: Type 2 Diabetes
Type 2 diabetes is one of the most common chronic conditions in the U.S...and one of the most expensive.
On average, individuals with diabetes face $12,000 to $19,000 per year in total medical expenses which include regular lab work, prescriptions, blood sugar monitoring supplies, specialist appointments, and sometimes emergency care.1 Though even with insurance, a 2023 GoodRx analysis estimated that individuals with type 2 diabetes spend between $275 to $400 per month out-of-pocket on managing their condition, including copays, supplies, and medications, totaling around $3,300 to $4,800 annually.2
Furthermore, the longer the disease progresses, the more the cost increases.
Over a lifetime, the total financial burden of managing diabetes ranges from $56,600 to $130,800, depending on the age at diagnosis.3 This doesn’t include the cost of complications like kidney disease, vision loss, or nerve damage (which while preventable) is still incredibly common when blood sugar is poorly controlled.
Example 2: Autoimmune Disease
Autoimmune conditions affect an estimated 24 million Americans and disproportionately impact women.4 From a financial standpoint, these conditions can be incredibly expensive to manage, especially when symptoms are moderate to severe or require advanced treatment.
For example, for individuals with rheumatoid arthritis, the average medical cost is around $12,500 per year, including labs, office visits, and medications.5 However, for patients requiring biologic therapies, (these are infusions like Remicade or Orencia) costs can increase drastically to over $36,000 per year.5 While insurance may cover some of these expenses, patients often still face high out-of-pocket costs due to deductibles, copays, and coinsurance in addition to uncovered services. It’s not uncommon for patients to pay several thousand dollars per year out-of-pocket, even with decent coverage.
Unfortunately,the financial strain doesn’t stop with just medical bills. Lupus, in particular, is associated with significant loss of income due to missed work or reduced capacity to work full time. In the U.S., people with lupus lose an average of $8,659 per year in productivity costs. When combined with direct medical expenses, the total financial burden climbs to over $20,000 per year for individuals of working age.6,7 Some studies estimate global costs as high as $50,000 per year, depending on the disease severity and common complications.6,7
We’ll dive deeper into income loss and disability-related challenges in the next section, but it’s worth noting how quickly autoimmune conditions can disrupt both health and financial stability.
Example 3: Multiple Chronic Conditions
Managing more than one chronic illness is increasingly common—and increasingly costly. According to the CDC, approximately 40% of U.S. adults live with two or more chronic conditions.8 While we often think of multiple chronic conditions being most common in older adults, over one-quarter of U.S. adults aged 45 to 64 are actually already managing two or more chronic diseases.9
A study published in the CDC’s journal Preventing Chronic Disease found that adults with combinations of conditions like arthritis, diabetes, heart disease, and hypertension faced average annual healthcare expenditures ranging from $7,117 to $20,016, depending on the combination.10 These figures reflect direct medical costs, but when you factor in indirect costs like lost productivity, absenteeism, and caregiver time, the burden increases significantly. So much so that people with multiple chronic conditions are three times more likely to experience financial hardship from medical bills, even when they have insurance.11
Managing multiple conditions often means navigating polypharmacy (multiple medications), countless appointments with various specialists, as well as complex treatment plans. These demands don’t just escalate costs but also increase the risk of disability.
Example 4: Chronic Illness That Prevents Work
Chronic illness doesn’t just affect how people feel day to day, but can also affect their ability to show up to work, keep a job, or pursue a career they once loved. And for many, that shift happens gradually: fatigue makes it harder to concentrate, flare-ups mean more sick days, appointments eat into work hours. Eventually, some people reach a point where they can no longer work at all.
When that happens, they may turn to Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). These programs can offer a financial safety net…but it’s a small one.
In 2024, the average monthly Social Security Disability Insurance (SSDI) payment was approximately $1,707.75, totaling about $20,493 annually.12 In contrast, the median annual earnings for full-time, year-round workers in the U.S. is around $60,070. That adds up to a nearly $40,000 gap in yearly income for individuals who leave the workforce due to chronic illness.
And the gap doesn’t end there. People on disability often lose access to:
- Employer-sponsored health insurance
- Retirement contributions
- Career growth and job satisfaction
- Daily structure and a sense of purpose
For individuals with complex chronic conditions like Lyme disease, autoimmune disorders, or ME/CFS, (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) this scenario is not uncommon. One study from the Federal Reserve Board found that households with disabilities experience a reduction in earnings of 15% to 70%, depending on the severity and type of illness.13
While functional medicine isn’t a magic bullet, it offers a proactive, systems-based approach that may help patients manage symptoms more effectively. Sometimes enough to regain stability, return to work, or prevent further decline. So let’s take a look at financial numbers when it comes to investing into a functional medicine approach.
What Functional Medicine Actually Costs (And What It Includes)
Functional medicine costs more upfront than a typical doctor visit…and for good reasons. It’s a different model of care: longer appointments, deeper testing, root-cause investigation, and an ongoing partnership to rebuild health from the ground up.
However, it’s important to know that costs and care structures vary widely across the functional medicine industry.
- Some clinics operate on a visit-by-visit basis, charging individually for each appointment.
- Others offer structured programs, often lasting 3 to 6 months, with bundled pricing.
- Many leading clinics use a membership model, offering ongoing access to a care team for a set monthly fee.
Because of these differences, the prices you’ll see are averages based on both available industry data and our clinical experience in the field. Actual costs can vary depending on factors like clinic size, practitioner expertise, location, and the intensity of support provided.
So what does that investment actually look like?
General Costs Across the Functional Medicine Industry14–18
While there’s no universal price tag for functional medicine care, here’s what’s typical across many clinics and practices in the United States:
- Initial consultations generally range from $350 to $950, depending on provider experience and geographic location.
- Comprehensive care programs (covering 6 to 12 months of support) are commonly priced between $5,000 and $15,000 per year.
- Structured short-term programs, often spanning 3 to 6 months, may cost around $5,000 to $9,500.
- Monthly membership models range from $300 to $700 per month, depending on the level of provider access, support services, and included resources.
- Specialty lab testing can add between $500 to $2,500 or more, depending on the number and type of tests recommended.
- Supplements and nutraceuticals are typically an additional, variable expense based on individual treatment plans.
It’s important to note that many clinics charge separately for laboratory testing, supplements, and medications because these costs are hard to predict upfront. This means that the total cost of care can vary widely depending on individual needs and the complexity of the case.
California Center for Functional Medicine Membership Model
At CCFM, we believe that functional medicine works best when it’s not rushed and when patients have consistent support at every step of the healing process. That’s why we’ve structured our care around a membership model, designed to provide you with not just expert guidance, but an ongoing partnership in your health journey.
Here’s what your first year of membership includes:
- One-time onboarding fee: $2,500
- Ongoing monthly membership: $375/month
The total investment for your first year is approximately $6,625 (excluding lab testing, supplements, or medications).
A CCFM membership includes:
- 7 Visits with an expert Functional Medicine Clinician over 12 months
- Unlimited Visits with a Functional Medicine Nutritionist & Health Coach
- Access to CCFM Community Educational Courses and Group Programs
- Direct Messaging with your care team between visits for support and adjustments
- Interval Progress Reports to monitor your progress and adapt your plan as you heal
- Team Support: Patient Care Coordinators are available to help guide you through the process, answer logistical questions, and ensure you feel fully supported throughout your membership.
We designed this structure to make sure you’re never alone in your healing journey. You’ll have consistent, real-time support, regular check-ins, and a team that’s invested in helping you reclaim your energy, resilience, and health.
What You’re Really Paying For: Value vs. Visits
When you look at functional medicine costs on paper, it’s easy to focus just on the number. But what truly shapes your experience isn’t just the number of visits or minutes in an office but also the depth of support, guidance, and partnership you receive along the way. With functional medicine, you’re investing in a completely different model of care; one that is focused on rebuilding your health, not just managing symptoms.
Here’s what you’re actually investing in:
- Getting your life back.
Real energy. Clearer thinking. A body that feels like yours again. - Personalized care and longer appointments.
You’re not rushed through a 10-minute checklist. You have the opportunity to be heard and for your story to help guide your care. - A care team looking at the whole picture.
It’s not just about lab results or prescriptions. We dive deep into root causes: nutrition, hormones, gut health, infections, stress, sleep, and more. - Advanced testing and the support you need between visits.
Healing doesn’t just happen at appointments. It happens with day-to-day guidance, protocol adjustments, and coaching when life gets in the way. - Fewer prescriptions, fewer ER visits, fewer flare-ups over time.
Functional medicine isn’t about quick fixes. It’s about reducing your need for emergency interventions in the first place. While it’s hard to quantify exactly, many people find that over time, these reductions help offset the upfront cost of care resulting in fewer surprise bills and more predictable, long-term spending on health.
The Long-Term ROI of Getting Better
When you think about investing in your health, it’s easy to focus on the cost. But what’s often overlooked is the return on investment; not just in dollars, but in energy, clarity, and quality of life. Because when your health improves, everything else does too!
Here’s what long-term healing can really give you:
- More energy and mental clarity
Imagine waking up rested, thinking clearly, and making it through the day without crashing. - Emotional resilience and mood stability
When inflammation, hormones, and nutrition are in balance, your brain and body can finally breathe. - Productivity and purpose restored
Many patients go back to work, start creating again, or simply feel like themselves for the first time in years. - Fewer medications and fewer medical emergencies
As symptoms improve at the root, the need for new prescriptions, urgent care visits, and flare-up management often declines.
The question isn’t just whether you can afford functional medicine but should also be: whether you can afford not to invest in your health.
What About Insurance?
It’s a fair question, and an incredibly common one.
In most cases, functional medicine services are not covered by traditional insurance plans. While certain lab tests may be covered or partially reimbursable and you may be able to use HSA or FSA funds, the core of functional medicine care is outside the insurance system.
That might sound frustrating at first, especially when we’re so used to thinking of healthcare as something that should be “covered.” But here’s what many people don’t realize:
Even with insurance, people managing chronic illness often spend thousands of dollars out-of-pocket every year.
- People with type 2 diabetes, for example, pay $3,300 to $4,800 annually out-of-pocket just to manage symptoms like we reviewed above.
- Patients with autoimmune disease often spend several thousand dollars on copays, labs, and medications, even with good insurance.
- Those with multiple chronic conditions frequently spend $1,000 to $2,000+ per year on deductibles, copays, and non-covered services.
So while functional medicine may not be “covered,” it’s designed for something insurance was never built for: preventing disease, reversing dysfunction, and helping you actually feel well again.
What’s It Worth to Feel Like Yourself Again?
By now, you’ve seen the numbers and the bigger picture behind them but I hope that you’ve also seen what your current approach may already be costing you (now or in the future).
Not just in money, but in:
- Time spent managing symptoms instead of solving them
- Energy lost to daily fatigue or flare-ups
- Opportunities missed because you just didn’t feel well enough
If you’ve been stuck in survival mode, just know that you don’t have to stay there.
And if you’re simply seeking to protect your health and avoid future issues before they start, you’re in the right place too.
Whether you're trying to recover your health or optimize it, functional medicine provides a different path. One focused on building resilience now, not waiting for problems to escalate later. Investing in your health today can mean fewer medications, fewer interventions, and fewer major health costs down the line.
If you’re curious whether this approach is right for you, we’d love to hear your story and help you explore what’s possible. Book your free discovery call today.
References:
1. Parker ED, Lin J, Mahoney T, et al. Economic Costs of Diabetes in the U.S. in 2022. Diabetes Care. 2024;47(1):26-43. doi:10.2337/dci23-0085
2. The True Cost of Diabetes. GoodRx. Accessed April 16, 2025. https://www.goodrx.com/conditions/diabetes/true-cost-of-diabetes
3. Zhuo X, Zhang P, Hoerger TJ. Lifetime Direct Medical Costs of Treating Type 2 Diabetes and Diabetic Complications. Am J Prev Med. 2013;45(3):253-261. doi:10.1016/j.amepre.2013.04.017
4. Why Women Are More Susceptible to Autoimmune Diseases. Accessed April 16, 2025. https://www.ccfmed.com/blog/why-women-are-more-susceptible-to-autoimmune-diseases
5. Hresko A, Lin J, Solomon DH. Medical Care Costs Associated with Rheumatoid Arthritis in the US: A Systematic Literature Review and Meta-analysis. Arthritis Care Res. 2018;70(10):1431-1438. doi:10.1002/acr.23512
6. Calderon O, Giffords ED, Kane K. What Do We Need? Accommodations in the Workplace: People with Lupus Share Their Work Experiences. Disabil Stud Q. 2023;42(3-4). doi:10.18061/dsq.v42i3-4.7705
7. Panopalis P, Yazdany J, Gillis JZ, et al. Health Care Costs and Costs Associated With Changes in Work Productivity Among Persons With Systemic Lupus Erythematosus. Arthritis Rheum. 2008;59(12):1788-1795. doi:10.1002/art.24063
8. CDC. Fast Facts: Health and Economic Costs of Chronic Conditions. Chronic Disease. December 10, 2024. Accessed April 18, 2025. https://www.cdc.gov/chronic-disease/data-research/facts-stats/index.html
9. Boersma P. Prevalence of Multiple Chronic Conditions Among US Adults, 2018. Prev Chronic Dis. 2020;17. doi:10.5888/pcd17.200130
10. Meraya AM. Chronic Condition Combinations and Health Care Expenditures and Out-of-Pocket Spending Burden Among Adults, Medical Expenditure Panel Survey, 2009 and 2011. Prev Chronic Dis. 2015;12. doi:10.5888/pcd12.140388
11. Becker NV, Scott JW, Moniz MH, Carlton EF, Ayanian JZ. Association of Chronic Disease With Patient Financial Outcomes Among Commercially Insured Adults. JAMA Intern Med. 2022;182(10):1044-1051. doi:10.1001/jamainternmed.2022.3687
12. Disabled-worker statistics. Social Security. Accessed April 18, 2025. https://www.ssa.gov/oact/STATS/dib-g3.html
13. Merchant Z, Troland E, Webber D. The Hidden Costs of Disability. Published online January 10, 2025. Accessed April 18, 2025. https://www.federalreserve.gov/econres/notes/feds-notes/the-hidden-costs-of-disability-20250110.html
14. Functional Medicine. Cleveland Clinic. Accessed April 25, 2025. https://my.clevelandclinic.org/departments/functional-medicine
15. Find a Practitioner | The Institute for Functional Medicine. Accessed April 25, 2025. https://www.ifm.org/find-a-practitioner
16. The Average Price of a Functional Medicine Visit. Fullscript. April 16, 2025. Accessed April 25, 2025. https://fullscript.com/blog/the-average-price-of-a-functional-medicine-visit
17. Pricing – The UltraWellness Center. Accessed April 25, 2025. https://www.ultrawellnesscenter.com/pricing/
18. Virtual Clinic - Dr. Michael Ruscio, DC. September 13, 2023. Accessed April 25, 2025. https://drruscio.com/virtual-clinic/
