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Yes. Most health insurance plans now cover chiropractic care – including Medicare and Medicaid.
As with other health benefits, there may be some restrictions and guidelines you may need to follow to ensure coverage of your chiropractic treatments, but chiropractic care is covered. Read on to learn more about what is covered and why as of January 2020 government-run health insurance programs like Medicare and Medicaid now approve chiropractic coverage.
The number one reason an insurance company provides any benefit is that it saves them money. Of course, benefits must be proven to be effective as well. For example, many insurers began covering fitness programs because they’re cheaper than treating heart disease and diabetes. That wasn’t just a guess, though. Studies prove that people who exercise regularly are typically healthier and suffer from fewer chronic illnesses than people who don’t.
Medical insurers would not cover chiropractic care if it had not been proven effective in treating a variety of musculoskeletal issues. Your insurance company may cover the following chiropractic services:
Most insurance will also cover x-rays to help diagnose your issue.
Manual manipulation of the spine to treat low back pain is the most commonly covered chiropractic treatment. For particular information about the benefits covered by your plan, please refer to your health insurance policy. Or, call our office and we’ll work with you and your insurer to verify your chiropractic coverage.
In addition to private insurance, such as group plans provided by employers or individual policies you buy through the Affordable Care Act (ACA, more commonly known as Obamacare), most government-run insurance programs now cover both chiropractic care and acupuncture. This includes:
Federal employee insurance plans also cover treatment provided by a licensed chiropractor.
While most private insurance companies have covered chiropractic care for more than 20 years, government-run health insurance programs did not approve chiropractic coverage until January of 2020. As per the Centers for Medicare & Medicaid Services (CMS), this change is due to the opioid epidemic. CMS determined that chiropractic care and acupuncture offered a safe, effective way to resolve low back pain. The goal is helping beneficiaries avoid highly addictive pain pills.
Insurance coverage for chiropractic treatment varies depending on who your provider is and the type of plan you have. At a minimum, most insurers require you to visit a chiropractor who is licensed to practice in your state. They may also require a short-term treatment plan coordinated with your primary care physician.
In some cases, you may need a referral from a healthcare provider to see a chiropractor. This is more common if your plan is a health maintenance organization (HMO). Most HMOs use a provider network and require referrals to see a specialist. However, not all insurance plans have this requirement. You need to check with your plan. Or, again, call us and we can help.
At Southwest Spine & Rehab, we accept most major insurance. This includes:
If you have a Medicare Supplement plan, please let us know to ensure proper billing.
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