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Does Medicare cover Chiropractic Treatments?

Aging can be a real pain – and we do mean that literally. In fact, studies show that up to 70% of seniors experience back pain at some point in their lives. 

When discomfort strikes, many turn to chiropractors to not only alleviate pain but also benefit from the holistic advantages of chiropractic care. Beyond immediate relief, chiropractic treatments offer improved posture, an increased range of motion, enhanced sleep quality, and reduced tension or stress. 

These broader health benefits make chiropractic care an attractive option for seniors looking to improve their overall well-being. However, amidst the potential advantages, a common question arises: “Does Medicare cover chiropractic care?” This article will explore whether Medicare provides coverage for these valuable services.

Are you among the 70% of seniors experiencing back pain? Don’t let questions about Medicare coverage for chiropractic care add to your discomfort. Discover the answers you need and find relief both physically and financially. Schedule an appointment with The Medicare Family today, and let’s navigate your Medicare options together!

Does Original Medicare Cover Chiropractic Care?

Medicare Part B, which covers medically necessary outpatient services, does provide coverage for chiropractic care under specific circumstances. However, it’s essential to understand the conditions under which Medicare will support your chiropractic visits.

Original Medicare will cover the manual manipulation of the spine when a medical professional deems it medically necessary to correct a subluxation. Subluxation refers to the misalignment of the spine’s vertebrae, which can lead to discomfort and pain. This coverage includes treatments by a qualified chiropractor for acute or chronic spinal conditions that require outpatient care.

What Does Medicare Advantage Cover?

Some Medicare Advantage plans may offer more extensive coverage for chiropractic care than original Medicare. The coverage provided by Medicare Advantage plans can vary, so it’s essential to review your plan’s explanation of benefits carefully. 

Some plans may cover chiropractic services for various conditions. However, your insurance provider may require you to visit an in-network chiropractor to receive full reimbursement. It’s crucial to check whether your chiropractor is within your plan’s network before seeking treatment.

What Does Medigap Cover?

Medicare Supplement plans, often called Medigap, fill the gaps left by original Medicare. When it comes to chiropractic care, if Medicare covers a particular service provided by a chiropractor to address a subluxation, your Medigap plan will step in and pay its portion. This can significantly alleviate your financial burden, especially considering that Medicare typically covers 80% of the approved amount for chiropractic services after you meet the annual Part B deductible.

Please note that Medigap plans, although standardized and offering similar benefits across different insurance providers, come in various plan types.

Each type provides different coverage, so choosing the one that best aligns with your healthcare requirements and financial situation is essential.

What Does Medicare Not Cover?

Does Medicare cover Chiropractic treatments - Doctor explaining x-ray results to patient

Essentially, Medicare will only cover services that a medical professional deems medically necessary, such as spinal manipulation for subluxation. This means that Medicare will not cover those visits if you’re visiting a chiropractor for general maintenance or preventative purposes.

Furthermore, when it comes to X-rays, Medicare has specific rules. It will pay for X-rays ordered by a physician if necessary to confirm a spinal subluxation requiring treatment. However, Medicare won’t cover those services if your chiropractor orders or interprets X-rays.

It’s also worth noting that Medicare will generally not cover similar services like acupuncture unless they specifically relate to treating chronic lower back pain. Understanding these coverage limitations will help you make informed decisions about your chiropractic care and related expenses.

Do I Need a Referral to See a Chiropractor?

In most cases, if you have original Medicare, you won’t need a referral to a chiropractor. However, your Medicare Advantage plan may require you to obtain a referral.

For example, your Medicare Advantage plan may require a treatment plan. This plan may include how many visits you need and how often. It may also have specific treatment goals, how to evaluate the treatment’s effectiveness, and the date of the initial treatment. 

How Many Chiropractic Visits Does Medicare Allow?

Medicare doesn’t impose a specific limit on the number of chiropractic visits it covers. However, the coverage is contingent upon medical necessity. As long as chiropractic care is medically necessary, Medicare will continue to provide coverage.

Straighten out your Medicare Options with The Medicare Family.

Navigating the complexities of Medicare coverage for chiropractic care can be daunting. However, you don’t have to go through this process alone. With over 40 years of experience, The Medicare Family is here to provide the support and guidance you need. We understand that everyone’s healthcare needs and budgets are unique. That is why we offer personalized assistance tailored to your specific circumstances.

Our dedicated team is committed to helping you every step of the way. Whether you have questions about Medicare coverage, want to explore different plans, or need help enrolling, we’ve got you covered. We’ll ensure you’re well-informed to make choices that align with your health and well-being goals. Schedule an appointment today and take the first step toward a healthier and more secure future with Medicare.

Sylvia Gordon, aka Medicare Mama®, is an expert on all things Medicare and Social Security. She is the 2nd Generation here at The Medicare Family and has served on the advisory boards of major insurance companies like UnitedHealthcare®, Cigna, and Anthem. In her free time, she can be found taking care of her animals (dogs, goats, peacocks, chickens), and reading a good book. Learn More.
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