Does Medicare Cover a Chiropractor?
Chiropractic care focuses on the neuromusculoskeletal system, bones, nerves, muscles, tendons, and ligaments. Chiropractors help patients through spinal adjustment and joint realignment. They find that by making these adjustments, they can also improve the function of other systems within the body.
When you visit a chiropractic office, the providers examine the position of your spine and your muscle reflexes. They may also perform other tests and take X-rays before diagnosing your condition and coming up with a treatment plan.
Along with spinal manipulation, chiropractors commonly provide treatments such as:
- Teaching relaxation techniques
- Hot and cold stimulation treatments
- Creating exercise plans
- Creating diet and weight loss plans and counseling patients for these conditions
In some instances, chiropractors perform massage therapy, use ultrasound, and prescribe braces or shoe inserts for pain relief.
Do your Medicare benefits cover chiropractic care services?
Original Medicare Part B (outpatient medical insurance) covers chiropractic care services only for manual manipulation of the spine, and only when it is necessary to correct vertebral subluxation. This is a condition where the spinal joints don’t move correctly even though there is still contact between the joints.
Medicare doesn’t cover the other services or tests that a chiropractor may prescribe as treatment. If the chiropractor prescribes or recommends other services that aren’t covered by your Medicare benefits, you might have to pay a portion or all the costs for these services. When you visit your Medicare-affiliated chiropractor, ask for details about your care and whether the services are covered by Medicare before going ahead with treatment.
Original Medicare Part B pays 80 percent of the final approved cost for covered chiropractic services. You are responsible for the remaining 20 percent after you’ve paid your Part B annual deductible.
Does Medicare Advantage pay for chiropractic services?
If you have a Medicare Advantage (or Part C) plan, your plan is required to cover, at minimum, all the benefits allowed by Original Medicare Parts A and B. This means that your plan must cover medical necessary manual manipulation of the spine to correct vertebral subluxation by a chiropractor – at least.
Some Medicare Advantage plans may offer extended chiropractic care services beyond what Original Medicare Part B covers. Because each Part C plan is different regarding additional coverage, you should check with your plan’s provider to find out what is covered.
Depending on what type of Medicare Advantage plan you have, you may be required to use health care providers and facilities that your plan includes in its set network of providers. You may not have coverage for services if you use providers outside the network. If you aren’t sure who’s included, you can find the information in the printed policy, on the provider’s website, or by calling your provider directly.
The amount you pay for coinsurance for chiropractic care depends on your individual plan.