Chiropractic care can be an excellent alternative treatment option for aches and pain throughout the body. Every year, over 20 million Americans visit chiropractors across the nation for various ailments. If you have been injured recently or experience frequent pain in your lower back, you may be considering visiting a chiropractor and wondering about whether your health insurance covers chiropractic care.
Does my insurance cover chiropractic care?
As stated above, seeking chiropractic care is fairly common. Fortunately, most insurance companies cover chiropractic care but do require a co-payment.
Chiropractic care is included in most health insurance plans, including major medical plans such as workers’ compensation, Medicare, specific Medicaid plans, Blue Cross Blue Shield, Cigna, Humana, and UnitedHealthcare. It is often also made available to all active-duty members of the armed forces, eligible veterans, and federal employees.
It is important to note that though these companies cover chiropractic care, their coverage may be limited and come with certain restrictions including:
- A referral from your primary care physician stating that care is medically necessary
- A cap how many times you can receive treatment within a month or year
- They may make you use in-network or approved chiropractors
- They may require your doctor to create an active care plan and follow it
Most insurance plans will only cover your short-term care during recovery and will not pay for maintenance visits or long-term care plans.
Due to the unique nature of health insurance and state mandates, we always recommend patients check with their insurance company and specific health plans as each will have different requirements, limits to care, and levels of coverage.
Some policies require that you meet your deductible, or a minimum dollar amount before your benefits will kick in. If your insurance does cover chiropractic treatment and you’ve met their specific requirements, you can expect to pay a portion of the cost of treatment, assuming you’ve met your deductible. If you haven’t met your deductible, you will have to pay the full price until you’ve met the minimum dollar amount for your policy.
Deductibles often reset on January 1st, so if you have met your deductible and are still needing treatment, now is the time to receive care to avoid having to begin paying toward your deductible again after the new year.
Why doesn’t health insurance cover maintenance care?
Coverage is often provided when care is part of an active treatment plan, meaning you are receiving care to treat a specific injury and that the treatment is currently improving your condition and symptoms. When significant treatment can no longer be expected from the care, treatment then becomes supportive rather than corrective, becoming maintenance care. Since most insurance companies only cover care for medically necessary treatments, maintenance care is not considered covered and therefore not payable.
What can I do if my health insurance doesn’t cover my care?
If your insurance doesn’t cover your health plan involving chiropractic care, talk to your doctor to see if they can help. They may be able to reach out to your insurance company on your behalf and explain their referral. You can also reach out to the company yourself and explain your story to them. If they do not cover your care, you may have to pay out of pocket for chiropractic care. Remember to discuss payment plans or other discounts you may be eligible for at our office during your consultation. Another option for those whose insurance doesn’t fully cover chiropractic care is supplemental coverage which can be used in addition to the healthcare you currently have.
Our team is always looking for new ways to help our patients receive quality and affordable chiropractic care. Whether you need an exam for an injury, rehabilitation services, or treatment for a chronic condition, we are here for you and happy to schedule an appointment to get the care you need. For more information on our services and how we can help you, please contact The Center for Spine, Sport, & Physical Medicine.