Low back pain remains the leading condition causing disability worldwide. Along with other aches that develop as we work and age, it is no surprise that people need to see a chiropractor at different points in life.
Health insurance covers a wide range of services, this makes it hard to keep track of every medical care it covers. For something that is commonly needed, a popular question asked is: does health insurance cover chiropractors?
This guide will answer your question and walk you through your options, deciding on whether your insurance covers chiropractic care or not.
Can Health Insurance Cover Chiropractors?
The short answer is: Yes, health insurance often covers chiropractic care but it depends on the plan.
While the answer is generally yes, not all chiropractic care is covered under health insurance. Most health insurance plans, including employer-sponsored plans, Medicare, and sometimes Medicaid, offer some coverage for chiropractic care. However, the details vary based on:
- Type of Plan: PPOs, HMOs, and high-deductible plans have different coverage rules.
- Medical Necessity: Many insurance companies only cover chiropractic care if it’s deemed medically necessary (e.g., for back pain or spinal issues) and not just for general wellness.
- Number of Visits: Some plans cap the number of covered visits per year (e.g., 10–20 sessions).
- Copays & Deductibles: You may have to pay a copay or meet a deductible before coverage kicks in.
In addition, most health insurance plans will only cover in-network chiropractors to ensure limited expenses. This does not mean that all out-network chiropractors are not covered, but if they are there will be reduced benefits and likely more out-of-pocket expenses. Make sure to find out if your chiropractor is listed as “in-network” for your insurance providers.
When Does Health Insurance Cover Chiropractors?
This question has already been partly answered above. Depending on the type of plan, medical necessity, and number of visits you can tell when health insurance covers chiropractors. However, we will go further to talk about some specifics.
- Medicare and Medicaid Coverage
Medicare covers spinal manipulation by a chiropractor under Medicare Part B. This is subject to you meeting the Medicare Part B Deductible for the year, after which Medicare will be responsible for 80% of the Medicare-Approved Amount ( i.e. the maximum amount that Medicare agrees to pay for a specific service)
The Medicare coverage for chiropractors doesn’t apply to X-rays, acupuncture, medical massages, or any other form of therapy.
Medicaid coverage, on the other hand, varies by state. Many states offer limited coverage based on factors such as medical necessity while other states offer no coverage at all.
- Insurance Plans That Cover Alternate Medicine
Some plans exclude chiropractic care entirely unless it’s part of an alternative medicine package. These packages may also include acupuncture or physical therapy. These types of coverage vary widely depending on the insurance provider, policy type, and state regulations.
They can include coverage from:
- Private health insurance
- Employer-sponsored health plans
- Marketplace Plans (E.g. some ACA-compliant health plans)
Coverage is not guaranteed. Some will cover chiropractic care partially or fully, while some might have no coverage. It is important to read the policies of your insurance providers or state institutions to find out if they cover alternate medicine or Chiropractic care.
How Much Does Chiropractic Care Cost?
You may also be interested in the cost of chiropractic care, especially if you do not fall under the insured categories and have to pay out-of-pocket.
The cost of chiropractic care ranges from $30 to as much as $250 depending on the services included. This puts the average session cost at around $90.
Some facilities offer free consultations and in turn have higher prices for their sessions, while others take between $50 – $150 for initial visits and maintain the same range for their sessions. Additional costs such as X-rays, MRIs, and laser therapy are not included.
If your insurance covers chiropractic care, you’ll usually pay a copay or coinsurance per visit, which can range from $10 to $50. However, coverage often comes with limitations, such as a cap on the number of visits per year or requirements for a referral.
Alternatives To Insurance-covered Chiropractic Care
What happens if you can’t afford chiropractic care or your health insurance does not cover it? Not to worry, there are still several options you can consider.
- Look for Discount Plans or Cash-Payment Options
Many chiropractors offer discounted rates for cash payments, prepaid packages, or membership plans. Some clinics provide sliding-scale pricing based on financial need.
You can also talk to your chiropractor about your financial situation and create a payment plan. They may be able to work with you to create a payment plan or provide services at a reduced cost.
- Look for Chiropractic Schools or Low-cost Clinics
Chiropractic schools may offer low-cost or free chiropractic care as part of their training programs. Contact the schools in your area to see if they offer such programs.
There may also be free or low-cost clinics in your area that offer chiropractic services. You can search online or contact your local health department or community health center for more information.
- Use HSA or FSA Funds
If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), you can use those tax-free funds to pay for chiropractic care. This helps lower out-of-pocket costs since you’re using pre-tax dollars.
HSAs are available to those with High Deductible Health Plans (HDHPs), while FSAs are employer-sponsored and usually require funds to be spent within the year.
- Consider Alternative Treatments
If you are unable to afford chiropractic care, you may want to consider alternative treatments, such as massage therapy, physical therapy, or acupuncture.
These other treatments are also rehabilitative and can solve your problems with a different method. Furthermore, some of these alternative treatments may be covered by your insurance plan or available at a lower cost.
Remember that it’s important to prioritize your health and seek care when you need it. Ignoring health issues because of your financial situation will only lead to more financial issues going forward.
How to find chiropractors covered by insurance
If chiropractors are your preferred choice and you would prefer to have it covered by a health insurance plan, then you would need to do a lot of research. This will include finding insurance providers that have in-network chiropractors or asking your preferred chiropractors if they accept insurance and can verify your benefits before your appointment.
If you have Medicare or Medicaid, you will also need to read their policies, check their websites, or speak with a representative to see if chiropractic care is covered in your state.
This process can be overwhelming and may not always lead to coverage. The best way to go will be to hire expert insurance brokers to do all the running around for you or your family, and we have just the right one.
IQ Financial Group: Your Trusted Insurance Brokerage
For over two decades, IQ Financial Group has dedicated its resources to brokering satisfactory health insurance plans for individuals, families, and groups.
We pride ourselves in delivering tailored plans and solutions after carefully looking through your demands and preferences. With our Medicare plans, we also assist seniors and eligible individuals with healthcare plans to satisfy their immediate needs.
Contact us on our website to secure expert brokers for your insurance plans today!
