Medicare for Chiropractic Care: What Does it Cover & What It Doesn’t Cover | Medicare Advantage Plans

Medicare for Chiropractic Care

Here in America, chiropractic care is considered a form of alternative or integrative care. It is often used alongside traditional medical care to achieve the desired result of spinal alignment. This hands-on treatment is based on the notion that the spine and its alignment affect the overall health of your body.

The National Center for Complementary and Integrative Healthcare reported in 2007 that more than 18 million people visited a chiropractor in the preceding year. Many forms of health insurance include benefits for chiropractor services these days. Fortunately, Medicare is one of them and seniors with Medicare Part B insurance can access these benefits.

Medicare for Chiropractic Care

What Medicare Covers in Chiropractic Care

When it comes to Medicare, outpatient care is covered under Part B. There are preventive care services, and then there are services that address medically necessary healthcare problems. This includes coverage for doctor visits, lab testing, medical equipment, necessary surgeries, home health care and much more.

You are responsible for a small annual deductible, and then Part B covers 80%. While you are responsible for the deductible and the other 20%, supplemental insurance coverage can be purchased to help you with these costs.

Chiropractic adjustments to treat subluxation of the spine are considered medically necessary, so Part B will pay for these services. It’s important that you follow your chiropractor’s treatment plan. He or she must be able to show that these adjustments are achieving functional results, such as less back pain or better ease of movement.

What Medicare Doesn’t Cover in Chiropractic Care

While the adjustments are covered, Medicare does not cover the initial exam by a chiropractor to determine if misalignment of your spine is present. Also, Medicare will cover an X-ray of your spine, but only if that X-ray was ordered by another physician for the purpose of determining whether a vertebral subluxation exists.

Today many chiropractic clinics offer an array of wellness services. There might be massage therapy available or treatment with electrical stimulation or hot/cold compresses. Some clinics also promote homeopathic care and dietary supplements. None of these things are covered by Part B, so speak with your chiropractor ahead of time to find out exactly what you can estimate to spend out of pocket.

Medicare Advantage Plans

Some people with Medicare choose to get their benefits through a Medicare Advantage plan. Advantage plans are private health plans that offer the same Part A and B services as Original Medicare. However, these plans generally have networks, and you should seek care from providers that are in the network in order to have the lowest out of pocket spending. Most plans offer online provider directories, so you can check your plan’s directory to find out which chiropractors participate in their plan.

Medicare Advantage plans also offer their care differently than Original Medicare. Instead of paying a deductible and then 20%, you will usually pay a copay for chiropractic services under your Medicare Advantage plan. Consult the plan’s Evidence of Coverage to see what copays will be collected from you at the time of treatment.

We are lucky that while Medicare does not cover acupuncture or naturopathy, it does recognize that chiropractic care can be very beneficial to us and our overall health. As long as you seek chiropractic care from participating providers, you should be able to take advantage of a chiropractor’s services in aligning your spine and improving your health.

Danielle Kunkle Roberts is the co-founder of Boomer Benefits, an agency that helps Baby Boomers navigate their entry into Medicare.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 28, 2019

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