Does Medical Insurance Cover Chiropractic Treatment?
The elevator pitch for chiropractic care carries several compelling points, from pain and migraine relief to a reduced reliance on opioids. However, the cost is not always pocket friendly. Forbes quotes $30 to $300 per visit, depending on your location.
The good news is that most health insurance options cover chiropractic care. Private companies have been doing it for over two decades. Also, government-sponsored options now acknowledge the importance of a chiropractor.
For example, Medicare and Medicaid started covering chiropractic care in January 2020. They established that it was a great alternative to opioid medication.
Still, there is much more to learn about how various health insurance providers treat chiropractic care. Here are some of the most common things to know.
How Do Medical Insurance Providers Cover Chiropractic Treatment?
Health insurance options that include chiropractic care often only do so when part of active treatment. This rule implies that the care has to be part of ongoing treatment for a specific injury or condition. It also means your situation continues to improve due to the treatment.
However, if continued chiropractic care no longer generates a significant improvement, the treatment is deemed supportive rather than corrective. This situation is referred to as hitting a plateau. In this case, the provider views your treatment as maintenance and not medically necessary. Unfortunately, most care plans often don’t include maintenance treatment.
It is also important to note chiropractic treatment is an alternative to medication or other procedures, although chiropractors would disagree. They think medical procedures should be an alternative to all-natural, holistic approaches. They are right.
However, due to the “alternative” label on chiropractic treatment, many insurance companies restrict how and what they cover. Consider reviewing your policy with your chiropractor to learn about any specific limitations in your plan. In the meanwhile, here are some more common restrictions to know:
Monthly or Yearly Cap
Some insurance plans will set a cap on how many times they cover your visits to the chiropractor in a year or month. The provider will not pay for additional visits outside the set cap.
Reference and an Active Care Plan from a Doctor
Most insurance plans have policies that demand you get a referral from your general practitioner (GP) or another specialist. This referral usually has to state that the care is medically necessary. Otherwise, they won’t sponsor your chiropractic treatment. Your doctor may also need to create an active care plan that you should follow.
Which Providers Cover Chiropractic Care?
As we mentioned earlier, most providers cover Chiropractic care nowadays, including government-sponsored healthcare insurance options. You can get care when using most plans from any of these insurers.
- Blue Cross
- Blue Shield
- United Healthcare
This list may not be exhaustive. Additionally, the extent of your coverage may depend on the kind of plan you have or your health insurance monthly cost. Consider contacting your provider to determine whether you are covered and by how much.
What Can You Do if Your Health Insurance Doesn’t Cover Your Care?
If your needs regarding chiropractic care are not in your health insurance, the first step is to talk to your provider. Find out whether you can upgrade, how soon they can cover you, and what it would mean for the monthly cost of health insurance.
Moreover, you can talk to your doctor to see what help or advice they can provide. For instance, they may reach out to your health insurance provider and explain why they referred you to a chiropractor.
You may have to cover your care independently if your insurance company does not offer favorable terms. It would be best if you had help creating a budget and spending limits. Professional help will enable you to stay within your limits.
Most health insurance options cover chiropractic care because providers understand its importance. However, you may find yourself having to dig into your pocket if you have to exceed the agreed number of visits or in case your provider does not cover chiropractic care. In this case, getting financial help would help you make better decisions.