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’re paying out of pocket.
When you’re on Medicare, individual chiropractic costs are covered, but only for particular ailments. Keep reading to learn more about the different types of Medicare and what they cover in terms of chiropractic care.
Key Takeaways
- Chiropractic care is used to treat health problems by realigning joints that are out of position.
- Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care.... does not cover chiropractic care because it is not an inpatient careInpatient care refers to care provided in a hospital or other inpatient facility. Inpatients are admitted and stay at least one night depending on their condition.... service.
- Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare... 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 plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B).... also cover chiropractic care to treat a misaligned spine, typically with a copaymentA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service.... per treatment.
- Medigap policies can provide additional help with chiropractic care costs after Medicare has provided coverage.
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 CMedicare Part C is Medicare's private health plan option. Also known as Medicare Advantage, Medicare Part C plans are a type of Medicare health plan offered by companies that contract with Medicare to provide all... 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 MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage.... 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
Medigap plans are also called Medicare Supplement plansMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage..... 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 deductiblesA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share.... for your chiropractic treatments if you require manual manipulation of the spine (if medically necessaryServices or supplies that are needed for the diagnosis or treatment of your medical condition and meet accepted standards of medical practice....) 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 providerA person or organization that’s licensed to give health care. Doctors, nurses, and hospitals are examples of health care providers.... 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-networkDoctors, hospitals, pharmacies, and other healthcare providers that agree to health plan members' services and supplies at a set price are in-network providers. With some health plans, your care is only covered if you get... 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.
Citations
- 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