Does medical insurance cover chiropractic treatment?” is a common question we get. Yes, in a nutshell, but there’s more to learn.
Depending on your insurance plan, each insurance provider treats chiropractic care differently.
Below are some of the more common ways that chiropractic treatment is covered by insurance.
What is Chiropractic Care and How Does It Work?
Chiropractic treatment aims to correct spinal and other joint misalignments. A chiropractor uses hands-on manipulation to realign bones, treat injuries, and relieve pain during your visit.
This is sometimes combined with medical massage, E-Stim, or other forms of therapy in some chiropractic offices.
Car accident injuries, sports injuries, sciatica, carpal tunnel syndrome, and other painful conditions can all benefit from chiropractic treatment.
The chiropractor will conduct a thorough examination and inquire about how your injuries have affected your life during your first visit. They might also perform an X-ray to aid in their diagnosis. Your initial appointment will assist your doctor in developing a treatment plan.
What Does Chiropractic Treatment Cost?
Chiropractic services are normally priced between $40 to $100 for each session. The cost, however, will vary depending on the type of treatment.
A free initial consultation may be offered, with future spinal manipulations costing between $50 and $60 each. Treatments that are more intense, such as medical massage therapy, will increase the overall cost.
If you’ve ever seen a chiropractor, the number of times you “needed” to return in order to keep your spine aligned and your pain at bay may have turned you off. Over the course of a year, many weekly visits add up.
Certain requirements must be followed, however, in order to receive the full value of your insurance coverage. You will be covered up to $10,000 if your doctor diagnoses you with an Emergency Medical Condition or EMC. Otherwise, you’ll be limited to $2,500.
The first 14 days after an accident can fly by, and there’s a strong chance you’ve had a misalignment without even realizing it.
This is why you should get treatment from a chiropractor as soon as possible following your injury.
However, many patients find that regular modifications improve their quality of life to the point where they don’t want to abandon other treatment options. Wouldn’t it be nice if their health insurance covered those chiropractor visits?
Is Chiropractic Care Covered by My Insurance?
Chiropractic treatment is gaining in favor as a viable alternative to medications and treatments. As a result, many insurance companies consider chiropractic care to be “alternative” care.
Instead of the other way around, we feel that most medical procedures should be alternatives to natural, holistic approaches like chiropractic care.
Chiropractic treatments can be a great alternative to traditional medicine for aches and pains all throughout the body. Every year, more than 20 million Americans seek treatment from chiropractors across the country for a variety of problems.
If you’ve just been injured or have recurrent lower back discomfort, you might be considering seeing a chiropractor and wondering if your health insurance covers chiropractic care.
As previously said, chiropractic treatment is fairly widespread. Most insurance companies, fortunately, cover chiropractic care, although they do need a co-payment.
Most health insurance plans, including major medical plans like workers’ compensation, Medicare, Blue Cross Blue Shield, Cigna, Humana, Aetna, and UnitedHealthcare, cover chiropractic care. It is frequently made available to all active-duty military personnel, veterans, and federal employees.
However, a number of factors influence whether your insurance plan covers chiropractic, including the services you want, your insurance policy (for example, PPO vs HMO), and your health insurance provider, among others.
Continuation on if Chiropractic Care Covered by My Insurance?
Most plans, for example, will cover the initial and some rehabilitative care for acute diseases, but not maintenance or wellness therapies.
It’s crucial to keep in mind that, while these companies may cover chiropractic services, their coverage may be limited and subject to certain limitations, such as:
- A referral from your primary care doctor saying that the treatment is medically essential.
- There’s a limit to how many times you can get therapy in a month or year.
- They may insist that you only see chiropractors who are part of their network or who have been approved by them.
- They may require your doctor to develop and implement an active care plan.
Most insurance policies will only pay for short-term care while you heal, not maintenance visits or long-term care plans. While many insurance companies, however, set restrictions on what they will cover as a result of being categorized as alternative care.
We always urge that patients verify with their insurance company and individual health plans because each will have distinct requirements, limits to care, and levels of coverage due to the unique nature of health insurance and state mandates.
What Types of Health Insurance Plans Include Chiropractic Care?
Most government-run insurance programs now include both chiropractic and acupuncture, in addition to private insurance such as group plans offered by employers or individual policies purchased under the Affordable Care Act (ACA, sometimes known as Obamacare).
This includes the following:
- Medicare is a government health-insurance program for Americans aged 65 and up, as well as individuals who qualify due to disability, amyotrophic lateral sclerosis (ALS), or end-stage renal illness (ESRD).
- Medicaid is a type of government-run health insurance. The Arizona Health Care Cost Containment System, or AHCCCS, is the name for Medicaid in Arizona.
- The Veteran’s Administration, or VA, is responsible for providing healthcare to members of the armed forces of the United States.
Treatment delivered by a licensed chiropractor is also covered by federal employee health plans.
Chiropractic services have been covered by most commercial insurance companies for more than 20 years, but government-run health insurance programs did not authorize chiropractic coverage until January 2020.
The opioid epidemic, according to the Centers for Medicare & Medicaid Services (CMS), is to blame for the move. Chiropractic and acupuncture were found to be a safe and effective way to treat low back pain by CMS.
The idea is to assist people to avoid taking highly addictive painkillers.
What Are Some of the Most Common Chiropractic Insurance Providers?
Of course, your local chiropractic office’s coverage will vary, but the most prevalent in are often covered.
- Blue Cross Blue Shield
- Blue Cross Blue Shield of Florida
What Should I Do If My Insurance Doesn’t Cover Chiropractic Care?
Despite the fact that chiropractic treatment has been demonstrated to be the most effective treatment for many musculoskeletal diseases and is growing in popularity across the United States, some insurance companies still refuse to cover it.
Patients may be able to cover their treatment costs out of pocket in some situations. This means if your insurance doesn’t cover the cost of a chiropractic adjustment (or if the doctor you want to see isn’t in your network), you may always pay for your appointments yourself.
A chiropractor or medical massage therapist, unlike other specialists, does not require a reference, and office visits are usually very reasonable.
Any doctor that tries to see you many times a week for an indefinite period of time should be avoided. While some conditions may necessitate more frequent visits than others, the majority of people can be properly treated with fewer visits.
Because of the success of the treatment choices, many patients still prefer to pay for chiropractic care out of pocket.
In these situations, choosing a chiropractor that specializes on mending patients swiftly and effectively, such as our doctors, is even more important.
What Can I Do If My Health Insurance Isn’t Covering My Treatment?
If your health plan includes chiropractic care and your insurance doesn’t cover it, go to your doctor to see if they can help.
They may be able to contact your insurance company and explain their referral on your behalf.
You can also contact the firm directly and tell them your story. You may have to pay for chiropractic care out of pocket if they do not cover it.
During your consultation, don’t forget to ask about payment plans or other discounts you might be eligible for.
Supplemental coverage, which can be used in addition to your present healthcare, is another alternative for people whose insurance does not fully cover chiropractic care.
What Questions Should You Ask Your Provider?
There are a few aspects of health care plans to consider if you’re seeking to figure out the specifics of your coverage.
You must first comprehend your deductible. This is the bare minimum you must pay before your insurance coverage kicks in.
A deductible does not alter based on the type of care provided, so if you haven’t met it yet, you’ll have to pay for chiropractic treatment until the deductible is satisfied. Your deductible will be reduced as a result of your chiropractic therapy.
Co-pays are the next concept to grasp. This is the amount you pay during a visit to a provider. Depending on whether the doctor is a primary care physician or a specialist, the fee is normally set at $25 or $50. Even if you have insurance, you may have to pay a modest fee for each modification.
After that, you’ll want to know which providers are in-network. The term “in-network” refers to a chiropractor who has agreed to collaborate with your insurance company to coordinate your care. You can still see someone who isn’t in your network, but your fees may be greater.
If you find out that your insurance plan doesn’t cover chiropractic services, you can appeal the decision. Insurance companies are frequently motivated by the potential to avoid future health concerns.
It’s usually lot less expensive for them to treat something with chiropractic adjustments upfront than it is to pay for major orthopedic surgery later on. As a result, some insurance companies may be prepared to pay for your treatment.
If you don’t have insurance, you may usually work out a payment plan with your chiropractor. Many may charge you less if you pay them directly rather than going via an insurance company.
What About Auto Insurance?
In contrast to health insurance, car insurance does not pay for therapy upfront.
If your claim is approved and the insurance company agrees to pay your charges, you’ll receive a lump-sum payment, usually after you’ve been treated. They normally do not make decisions about what kind of care you can get.
You can pay off any outstanding costs under your insurance plan with a car insurance settlement.
Co-pays, expenditures that count toward your deductible, and continuous care are all examples of this.
“Does medical insurance cover chiropractic treatment?” is a common question we get.
Yes is generally the short answer.
Many insurance companies are electing to cover chiropractic care as the effectiveness and popularity of the treatment grows across the United States.
They offer these advantages as part of their “alternative care” program, which allows them to limit the services they offer.
However, these restrictions may include a cap on the number of visits or the amount of money that can be spent over the course of a month or year.
Furthermore, they may limit chiropractic treatment to patients who have been referred by a primary care physician. Schedule an appointment for treatment now if you’re interested in learning more about how chiropractic may help treat a variety of ailments organically in Erie or Longmont.