If you’ve recently injured your back or are struggling with chronic pain, you might find it helpful to go to a chiropractor and receive spinal adjustments. This procedure is useful, but sessions can add up if you pay out of pocket.
Individual chiropractic costs are covered when you’re on Medicare, but only for particular ailments. Keep reading to learn more about the different types of Medicare and what they cover regarding chiropractic care.
- Medicare Part A does not cover chiropractic care because it is not an inpatient service.
- Medicare Part B covers 80 percent of chiropractic care to treat a misaligned spine once the annual Part B deductible is paid.
- Medicare Part B will not cover other services or treatments ordered by your chiropractor.
- Medicare Advantage plans also cover chiropractic care to treat a misaligned spine, typically with a copayment per treatment.
- Medigap policies offer additional help with Medicare-approved chiropractic care costs.
What Is Chiropractic Care?
Chiropractic care is performed by licensed chiropractors who use their hands or special instruments to apply a controlled and sudden force to the neck, spine, and/or other joints in your body. During chiropractic treatment, it is normal to hear loud cracking sounds as the chiropractor adjusts your joints during treatment. Spinal manipulation treatments are used to increase spinal mobility and enhance the body’s physical ability.1mayoclinic.org, “Chiropractic adjustment“, Accessed November 10, 2021
Does Medicare Cover Chiropractic Procedures?
The answer to “does medicare cover my chiropractic costs?” is sometimes, and usually only as a treatment for specific injuries.
Here is a breakdown of each type of Medicare and what kind of chiropractic procedures it covers, so you have all the information you need before booking an appointment.
Medicare Part A
Unfortunately, Medicare Part A does not cover chiropractic services. Part A covers hospital care and emergency services. Chiropractic care doesn’t qualify as an emergency service, since it’s typically an elective service in a doctor’s office, not a hospital.2Medicare.gov, “Chiropractic services“, Accessed November 10, 2021
Medicare Part B
Part B goes beyond Part A in that it covers emergency needs as well as preventative care. What services qualify as preventative care are sometimes challenging to define, but services like flu shots or a yearly visit to your primary care physician usually qualify.
Medicare Part B covers spinal adjustments, but only as a treatment plan for a condition called spinal subluxation. To get this procedure covered, you’ll need to work with a licensed chiropractor to provide an official diagnosis.
The number of treatments Part B covers will also depend on your situation and how many visits your doctor thinks you need. Part B will cover 80 percent of your costs after you meet your yearly deductible. Medicare will not, however, cover any extra tests (such as X-rays) that your doctor orders as a part of your treatment plan.2Medicare.gov, “Chiropractic services“, Accessed November 10, 2021
Medicare Part C
Private insurance companies offer Medicare Part C plans, also known as Medicare Advantage. Many Medicare Advantage plans offer chiropractic care coverage, but if you have one, you’ll need to contact your primary insurance provider to find out which procedure it covers. If you have Original Medicare benefits, and you need more coverage for chiropractic care, the Medicare Advantage Plan Finder tool will help you find a plan with chiropractic coverage.3Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 10, 2021
Medigap plans are also called Medicare Supplement plans. These plans help you fill in some coverage gaps in your primary Medicare plan. Purchasing a Medigap plan may be able to help you cover your copays and deductibles for your chiropractic treatments if you require manual manipulation of the spine (if medically necessary) to correct a subluxation.4Medicare.gov, “What’s Medicare Supplement Insurance (Medigap)?“, Accessed October 29, 2021
How To Find a Licensed Chiropractor
Medicare covers chiropractic care when performed by a licensed medical doctor or other health care provider such as a physician assistant or nurse practitioner. In addition to their license or certification, they must also have:
- A Doctor of Chiropractic (DC) degree from a college accredited by the Council on Chiropractic Education (CCE).
- A license to practice chiropractic care in the state where the treatments take place.
You can find a licensed chiropractor meeting Medicare’s requirements in several ways:
- Check with your state chiropractic regulating agency.
- Use the ChiroCare Find a Provider Near You tool.
- Contact your Medicare Advantage plan and ask for a list of in-network providers.
Learn More About Paying for Chiropractic Care
If the answer to “Does Medicare Cover Chiropractic Care?” wasn’t what you wanted to hear, there are other ways to pay for treatment. First, you can speak to your doctor and see if they offer different payment plans that will make your bills more manageable.
Another option is choosing a Medicare Advantage plan that covers more chiropractic services. MedicareWire can help you find the Medicare plan that’s right for you and your unique needs. Use our plan finder tool and compare the top Medicare Advantage plans near you so you can find one that suits your healthcare needs.
Important: Your doctor may recommend you get services more often than Medicare covers. Or, they may prescribe services that Medicare does not cover. When this happens, you may have to pay some or all of the costs out-of-pocket. Ask your doctor questions until you fully understand why your doctor is recommending services. Be sure to ask “Does Medicare Cover Chiropractic Care for Seniors?” before you agree to receive the chiropractic care you need.
- 1mayoclinic.org, “Chiropractic adjustment“, Accessed November 10, 2021
- 2Medicare.gov, “Chiropractic services“, Accessed November 10, 2021
- 3Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 10, 2021
- 4Medicare.gov, “What’s Medicare Supplement Insurance (Medigap)?“, Accessed October 29, 2021