Does insurance cover chiropractic care? Chiropractic care is a popular alternative treatment option for individuals suffering from musculoskeletal issues, particularly back and neck pain.
It involves hands-on spinal manipulation and other treatments aimed at improving alignment and function.
Many people seek chiropractic care for pain relief, injury recovery, and overall wellness. However, one of the primary concerns for patients considering chiropractic care is whether their health insurance will cover the costs associated with these treatments.
Health insurance coverage for chiropractic care varies widely depending on the provider, the specific insurance plan, and the medical necessity of the treatment. Some insurance policies provide comprehensive coverage, while others may offer limited or no coverage at all.
How Insurance Coverage For Chiropractic Care Works
Insurance coverage for chiropractic care generally depends on the type of health plan you have. Many health insurance companies recognize chiropractic care as a legitimate medical service.
However, the extent of coverage can differ based on various factors. Here are factors that affect chiropractic insurance coverage:
- Co-pays and Deductibles: Out-of-pocket costs may still apply even if the treatment is covered.
- Type of Health Insurance Plan: Employer-sponsored plans, individual plans, Medicare, and Medicaid may have different policies regarding chiropractic care.
- Number of Covered Visits: Many plans have a cap on the number of chiropractic visits covered annually.
- Medical Necessity: Some insurance providers require a doctor’s referral or proof that the treatment is medically necessary.
- Network Restrictions: Some plans only cover services from in-network chiropractors.
Insurance Plans That May Cover Chiropractic Care
Different types of health insurance plans have varying levels of chiropractic care coverage. It is essential to understand how each type of plan works to determine if chiropractic services are included. Those insurance plans include:
Private Health Insurance
Most employer-sponsored and individual health insurance plans offer some level of chiropractic care coverage, but the terms can vary. What’s more:
- Some plans cover chiropractic visits as part of their standard benefits.
- Certain plans limit the number of covered visits per year
- Others may require policyholders to meet their deductible before coverage kicks in.
Workers’ Compensation And Auto Insurance
Workers’ compensation insurance may cover the cost if a chiropractic visit is necessary due to a workplace injury. Auto insurance policies with personal injury protection (PIP) may include chiropractic care for accident-related injuries.
Medicare And Medicaid
Medicare Part B covers chiropractic adjustments but only for spinal subluxation (misalignment). Furthermore, patients usually have to pay a portion of the costs. On the other hand, Medicaid coverage for chiropractic care varies by state, with some states providing limited benefits.
How To Determine If Your Insurance Covers Chiropractic Care
To determine whether your insurance plan covers chiropractic care, you should take a few important steps to verify your benefits. Here’s how:
- Review Your Insurance Policy: Read the fine print of your health insurance plan to see if chiropractic services are included.
- Contact Your Insurance Provider: Call the customer service number on your insurance card to ask about chiropractic benefits.
- Ask Your Chiropractor: Some chiropractic offices assist patients in verifying their insurance benefits.
- Obtain a Referral if Needed: Some plans require a primary care physician’s referral before covering chiropractic care.
What To Do If Chiropractic Care Is Not Covered
If your insurance does not cover chiropractic care, there are still alternative ways to afford treatment. Here are alternative payment options:
- Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs): These accounts allow you to use pre-tax dollars for medical expenses, including chiropractic care.
- Discount Chiropractic Programs: Some clinics provide membership plans with discounted rates for uninsured patients.
- Out-of-Pocket Payment: Paying directly for chiropractic care may be a viable option, especially for those who do not require frequent visits.
- Payment Plans: Many chiropractors offer flexible payment options to make care more affordable.
Frequently Asked Questions
How Much Does Chiropractic Care Cost Without Insurance?
The cost of chiropractic care varies depending on location, provider, and treatment needed. On average, a single session can cost between $90 and $200.
Does Insurance Cover Chiropractic Care For Back Pain?
Many insurance plans cover chiropractic care for back pain, especially if it is deemed medically necessary. However, coverage limits may apply.
Do I Need A Referral For Chiropractic Care?
Some insurance plans require a referral from a primary care physician before covering chiropractic treatments.