When Does Medicare Cover Chiropractic Treatments?
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Chiropractic care is covered by Medicare Part B, Medicare Advantage and Medicare Supplement plans. Your out-of-pocket costs will vary by Medicare plan.
In most cases, chiropractic adjustments will only be covered if they are medically necessary, rather than a routine back adjustment. For access to routine chiropractic care, choose a Medicare Advantage plan that has robust benefits such as the plan from AARP/UnitedHealthcare.
Which parts of Medicare cover chiropractic care?
All Medicare enrollees will have coverage for medically necessary chiropractic care to correct a subluxation, which means that the vertebrae is misaligned.
Medicare type | Chiropractic coverage | Typical cost |
|---|---|---|
| Part A (hospital insurance) | ||
| Part B (medical insurance) | $6 - $10 | |
| Part C (Medicare Advantage) | $5 - $20 | |
| Part D (prescription drugs) | ||
| Medicare Supplement (Medigap) | Usually $0 |
If you have Medicare Part B, you'll pay 20% of the cost of chiropractic care at a facility that accepts Medicare. This is often reduced to $0 if you have a Medigap plan in addition to Medicare Part B. With a Medicare Advantage plan, chiropractic coverage typically costs between $5 and $20 and can sometimes include routine or maintenance adjustments.
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Medicare Part B chiropractic guidelines and exclusions
Medicare Part B will only pay for chiropractic care if the treatment is medically necessary. The most important thing to know is that you need to go to your doctor before the chiropractor. If the physician determines that you have a spinal subluxation (misaligned vertebrae), you will be able to use your Medicare Part B plan to help pay for a chiropractic adjustment.
Requirements for chiropractic coverage through Medicare Part B
- Must be medically necessary (documented either through a doctor's exam or an X-ray).
- Will only cover spinal manipulation for subluxation (an altered position of the vertebrae).
- Must address a specific problem (no preventive care or maintenance adjustments).
- Can get an unlimited number of treatments as long as they're medically necessary.
Chiropractic coverage exclusions
- No coverage for other services provided by a chiropractor such as massage therapy, ultrasound treatments or traction therapy.
- No coverage for other procedures ordered by a chiropractor such as X-rays or diagnostic tests. These tests can be used by a chiropractor to demonstrate medical necessity, but the tests will only be covered if they're ordered by a medical doctor.
Part B does not have a limit on the number of chiropractic adjustments it will cover. However, for subsequent treatments, the severity of the medical issue may determine what's needed to qualify as medically necessary. In most cases, you will need to show the treatment is "reasonable and necessary" through a spinal exam, an assessment of improvement and an evaluation of treatment effectiveness.
Need other help to manage chronic back pain?
Medicare Part B will cover up to 12 acupuncture treatments in three months and a maximum of 20 acupuncture treatments per year.
How much will you pay for chiropractic care with Medicare Part B?
With Medicare Part B, you'll pay 20% of the procedure cost, which is typically between $6 and $10.
You must go to a chiropractor that accepts Medicare for your bill to be covered, otherwise you risk paying the whole amount for the service.
The cost of your chiropractic bill is based on the number of spinal regions that need manipulation.
Chiropractic adjustment | Total procedure cost | Your portion of the bill (20%) |
|---|---|---|
| 1 to 2 regions of the spine | $28 | $6 |
| 3 to 4 regions of the spine | $40 | $8 |
| 5 regions of the spine | $52 | $10 |
Average Medicare-approved amount
Remember to always seek out medical advice from a health care professional about what type of treatment is best for your needs.
Does Medicare Advantage cover chiropractic care?
Medicare Advantage plans cover chiropractic care, and your costs will typically be between $5 and $20 per adjustment.
The Medicare Advantage plan determines how much you'll pay for chiropractic treatments. Some plans may also provide chiropractic benefits beyond what Medicare Part B offers, including routine chiropractic appointments. This means you can get a maintenance treatment without needing the medically necessary documentation of having altered vertebrae positioning.
Medicare Advantage plans are more like traditional insurance because you'll sign up for a single plan that provides unified medical coverage. Benefits vary widely, and you should check your policy about which chiropractic services your plan will cover.
Providers usually have trends about how they classify chiropractic treatments, and the table below shows the average costs and requirements for some major Medicare Advantage providers. Note that preauthorization may be required.
Medicare Advantage provider | Medically necessary chiropractic adjustments (average) | Routine chiropractic care |
|---|---|---|
| AARP/UnitedHealthcare | $20 in-network copay | Sometimes covered |
| Aetna | $5 copay | Usually not covered |
| Anthem | $20 copay | Not covered |
| Cigna | $10 copay | Not covered |
| Humana | $20 copay | Usually not covered |
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Does Medicare Supplement cover chiropractic care?
Medicare Supplement (Medigap) covers chiropractic services, often reducing the cost of medically necessary chiropractic treatments to $0.
Chiropractic coverage with Medigap is based on what's covered with Medicare Part B, and these supplemental plans lower your out-of-pocket expenses for medical care.
With Medigap, all of the Medicare Part B chiropractic restrictions and exclusions apply. That means Medicare coverage is limited to manual manipulation of the spine that is medically necessary. You'll also need to visit your doctor before the chiropractor.
All Medicare Supplement plans will reduce your Medicare Part B coinsurance by 50% to 100%. In the table below, you can see your copayment cost for chiropractic care after you've met your deductible.
Medigap plan | Your cost for medically necessary chiropractic adjustments |
|---|---|
| Plan A | $0 |
| Plan B | $0 |
| Plan C | $0 |
| Plan D | $0 |
| Plan F | $0 |
| Plan G | $0 |
| Plan K | 50% of costs (about $3 to $5 per treatment) |
| Plan L | 25% of costs (about $2 to $3 per treatment) |
| Plan M | $0 |
| Plan N | $0-$20 |
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Frequently asked questions
How many chiropractic visits will Medicare allow in a year?
There is no limit on the number of chiropractic adjustments that Medicare will cover, but each appointment must be medically necessary to treat an altered vertebrae position.
How much does Medicare pay for a chiropractic adjustment?
Medicare Part B covers 80% of the cost of Medicare, and your portion of the bill will typically be between $6 and $10 after you've met your annual deductible.
When did Medicare start covering chiropractic care?
In 1972, President Nixon signed Public Law 92–603, adding chiropractic treatments as a covered service in Original Medicare. This change was made following a seven-year lobbying campaign after the creation of Medicare in 1965 specifically excluded chiropractic services.
In recent years, there has been renewed interest in expanding chiropractic and acupuncture coverage as a way to help enrollees manage pain without opioids.
Are chiropractors covered by health insurance?
Most individual and family health insurance plans cover chiropractic care. This includes both insurance purchased through an employer and plans purchased through the Affordable Care Act (ACA) marketplace. Coverage details vary, so check your policy to see if your insurance will pay for spine adjustments.
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