Does Insurance Cover Chiropractic Care?
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Summary:
Many health insurance plans do cover chiropractic services, but you will want to check your insurance coverage before making an appointment. Most plans that cover chiropractic care will likely only do so if the treatment is deemed medically necessary by your primary care physician. Additionally, your insurance company may have different deductibles, copayments, and benefit limits for chiropractic coverage. If your insurance doesn’t cover chiropractic care, you have other options to pay for the treatment.
Many adults suffer from neck and back pain. In fact, according to a Gallup poll, 65% of Americans have sought treatment for back or neck pain at some point in their lives. Luckily, if this happens to you, there is a good chance that your health insurance will pick up at least some of the costs of chiropractic treatment.
Below, we explore how insurance coverage works with chiropractic care and some other options to seek if your medical insurance doesn’t cover chiropractic treatment. But first, let’s take a closer look at exactly what chiropractors do and how they’re trained.
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What is chiropractic treatment?
Practitioners of chiropractic care help to prevent and treat patients’ neuromusculoskeletal systems. They make adjustments to the neck, back, and spine in order to ease pain, correct alignment issues, and treat injuries.
Chiropractic services may also include treating joint pain, muscle spasms, and chronic muscle pain. As part of your treatment, a chiropractor may also discuss general health issues like diet, exercise, and healthy habits. The adjustments can be more effective if a patient lives a relatively healthy lifestyle.
Chiropractic training
It’s no walk in the park to become a chiropractor. A student needs to first complete a four-year premedical undergraduate degree and then go on to attend an accredited chiropractic school, which can take 4-5 years. A minimum of 4,200 hours of classroom, laboratory, and clinical experience is required to be a licensed practitioner.
Once an individual completes the training, they must pass an exam and get a chiropractic license in the state where they plan to practice. Chiropractors must also undergo regular continuing education to maintain their licenses and continue to practice.
Does insurance cover chiropractors?
The good news is that a lot of major medical plans will cover chiropractic treatment for acute or short-term conditions when you are on an active care plan. An active treatment plan means you are receiving care to address a specific injury or body pain, and your chiropractic treatment is causing your symptoms to improve. Thus, you will probably be covered if your primary care doctor deems the treatment medically necessary and expects you to continually get better.
Some health insurance plans might have limitations on how many chiropractic visits you can have, dollar limits, and referral requirements. In addition to getting a referral from your primary care physician, make sure your provider is included in your network of approved chiropractors. Otherwise, you might have to pay full price out of pocket.
What health insurance plans won’t cover
Common medical insurance restrictions usually dictate that you can’t just go to a chiropractor any time you feel like it. As previously stated, your health insurance probably won’t cover chiropractic care unless it’s in response to a specific condition or injury.
Therefore, certain chiropractic services, such as maintenance care or wellness treatments, may not be covered by your health insurance.
How much does a chiropractic visit cost?
Several factors determine how much you’ll pay for chiropractic visits. The costs can fluctuate by state or region. But prices can also vary depending on the nature of your condition or injury, the experience of the chiropractor, and the specific location and type of office. For example, you will likely pay more at a swanky private practice as opposed to a clinic with multiple providers.
That said, at an initial consultation, you can expect to pay anywhere between $30-$200. After your evaluation, your chiropractor will be able to give you an idea of what you will be charged for subsequent visits. Ideally, your insurance provider will cover some or all of these visits.
To find out what portion your particular health insurance will cover, check your summary of benefits and coverage document for details. Or you can call your health insurance provider for more information.
What about deductibles?
Deductibles vary as wildly as health insurance plans do. In general, the higher the deductible, the lower the monthly premiums and vice versa. You will usually need to meet your deductible before your insurance coverage can begin. Keep in mind that your insurance policy may have certain restrictions and different requirements and deductibles for chiropractic care as opposed to your usual healthcare needs.
What if my insurance doesn’t cover chiropractic care?
In the event that your insurance company doesn’t cover chiropractic care, you have a few other options.
Workers’ compensation
This option only applies if you are injured on the job. But if you were, your firm’s workers’ compensation plan may include allowances for chiropractic care. Talk to your employer’s human resources department to see if this is an option for you.
Auto insurance
If your injury occurred because you were involved in a car accident, your medical costs, including chiropractic care, may be covered by auto insurance. The costs could be covered by your insurance or the other driver’s, regardless of who was at fault or who was driving.
HSAs and FSAs
If you have a health savings account (HSA) or a flexible savings account (FSA), you can use the money in one of those accounts to help pay for chiropractic costs. HSAs and FSAs work pretty much like traditional savings accounts, except the money can only be used for qualifying medical expenses. They come in handy when your insurance is lacking.
Pro Tip
One benefit of HSAs and FSAs is that they’re funded with pretax dollars, which lowers your taxable income.
Chiropractor financing
Some clinics may have financing options available, which can make it easier to pay for your treatment by spreading the costs out over months or even years. Many clinics provide private, independent financing, while others may work through a third-party lender.
Medical credit cards
A medical credit card is another option to consider. Medical card issuers of this kind sometimes have introductory plans that charge 0% interest for up to two years. If you qualify for the card, this could be a great way to pay for your chiropractic care over time without having to pay any interest. Just be sure to pay off the balance before the introductory period is up.
Pay out of pocket
If you’ve exhausted your options, you may have no choice but to pay for your treatment out of your own wallet. But if you do, be sure to keep your receipts because you may be able to get a medical deduction on your income taxes. Find more tips and information on how to pay your bills with SuperMoney’s guide to medical financing.
If your chiropractic costs are adding up, a personal loan may be a good option to pay for your medical expenses.
Pro Tip
Due to varying state regulations and unique insurance plans, be sure to thoroughly examine your summary of benefits and coverage or talk to your insurance provider about the coverage you can expect to receive.
FAQ
How often should you see a chiropractor?
How often you need to visit the chiropractor depends on the type of treatment you need and the condition you’re in. For example, someone with a major spinal injury from falling off a ladder may require more work than a person who got whiplash from being rear-ended in a car accident.
Typically, chiropractic care requires ongoing treatment, meaning one or two sessions aren’t going to do the trick. But how many visits you do need will be determined by your medical doctor and your chiropractor as your therapy progresses.
Is a chiropractor a doctor?
Chiropractors do not have medical degrees (M.D.), so they are not medical doctors. However, they are doctors of chiropractic care and must hold a Doctor of Chiropractic (D.C.) degree to practice.
Additionally, chiropractors study many of the same subjects as M.D.s, such as anatomy, orthopedics, and physiology, to name a few. So, while chiropractors aren’t medical doctors, they are highly skilled professionals trained to work on the human body in therapeutic ways.
Can a chiropractor mess up your back?
According to the Mayo Clinic, chiropractic treatment is safe when performed by trained and licensed chiropractic care providers. However, on rare occasions, serious complications can occur. Complications might include a herniated disk or worsening of an existing disk herniation, compression of nerves in the lower spinal column, or a certain type of stroke after neck manipulation.
It’s not recommended that you go to a chiropractor for any reason without checking with your doctor first. Some conditions, such as osteoporosis or spinal cancer, can be exacerbated by chiropractic treatments.
Does Medicare or Medicaid insurance cover chiropractic care?
Medicare Part B will only cover manual manipulation of the spine by a chiropractor, or other qualified providers, to correct a vertebral subluxation. This is when the spinal joints fail to move properly, but the contact between the joints remains intact. Medicare doesn’t cover other services or tests a chiropractor orders, including X-rays, massage therapy, and acupuncture (unless the acupuncture is for the treatment of chronic low back pain).
In the case of Medicaid insurance, coverage of chiropractic care varies by state. Because the treatment is not considered mandatory, it’s up to each state to decide to cover it. But many states do. There are also different limitations among states. For example, some limit the number of visits funded per year, while others place an annual funding cap on chiropractic treatment per person.
Key takeaways
- Most insurance plans cover chiropractic care, at least for short-term acute conditions like back or neck injuries.
- In order to receive treatment from chiropractors, your condition usually must be deemed a medical necessity by a doctor.
- Typically, your insurance provider will not provide you with chiropractic coverage for maintenance care or wellness treatments.
- If your insurance plan does not cover chiropractic care, you can pay for your treatment with HSAs, FSAs, or financing through your provider. Or you could pay out of your own pocket with cash, a credit card, or a personal loan.
- You may be able to receive a medical deduction on your taxes for any chiropractic care medical expenses that you pay for out of pocket.
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