Does Your Medicare Cover Chiropractic Services?

By: Agnus Smith
Published: Wednesday, September 26 2018
Last Updated: 3 years ago

An average of about 22 million people seek relief from back, neck and joint pain by seeing their local chiropractor. The theory behind chiropractic services is to give the patient the proper alignment of his or her body. When the musculoskeletal structure is properly aligned, the body will help to heal itself.

Chiropractors manipulate the spine to restore joint mobility that has been injured by painful events like repetitive stress, sitting with no back support or bad falls. However, the cost of seeing a chiropractor can quickly add up, which leaves many wondering if Medicare covers chiropractic services.

Does Medicare Offer Chiropractic Coverage?

Chiropractic care is covered under Part B. Medicare chiropractic services will cover the manual manipulation of a person’s spine in order to correct a subluxation. Patients will not need an X-ray to show that they have a subluxation of the spine. Patients will need a few adjustments before any relief is acquired.

There are no restrictions on how many Medicare chiropractic visits to the chiropractor a person can have for the manipulation of the spine to correct a subluxation. The proper chiropractic modifiers must be used in order for payment to be sent from Medicare to the chiropractor.

What Chiropractic Services Are Covered?

Medicare Part B will cover the hands-on manipulation of the patient’s spine when it is medically necessary. When one or more of a person’s bones in the spine are out of position a chiropractor who is qualified to perform manipulations can medically adjust your spine. Medicare chiropractic coverage is 80% covered, with the correct chiropractic modifiers, under Medicare Part B. The patient is responsible for the other 20%. Any other tests that the chiropractor wants to be done will need to be covered by other insurance or by the patient.

Out-of-Pocket Chiropractic Medicare Expenses

If a patient only has Medicare chiropractic coverage the cost to the patient would be the 20% that Part B does not cover. The specific amount each patient would pay would depend on if they had other insurance, how much the chiropractor charges and where you get chiropractor services. You may also ask if your chiropractor will take an assignment, which will lower your cost.

Medicare chiropractic patients would be responsible for the cost of other tests, X-rays or massage therapy that their chiropractor orders. Medicare chiropractic services, Part B does not cover Acupuncture services. The patient would be responsible for the full cost of this service.

Cost of Seeing A Chiropractor Without Medicare

Each type of chiropractic care has a different cost. For general chiropractic treatments, the cost of services can range from about $30 to $200 or more per session. Usually, consultations with the chiropractor are free. A regular therapy session could cost $65 on the average. More advanced care or intensive care will cost more. Chiropractic treatments are usually done at least twice a week for a certain period of time.

The location in which you live will affect the cost of your chiropractic care. It is reasonable to say that a chiropractor in Beverly Hills will cost a lot more than a chiropractor in Montana. In towns and counties where more people need chiropractic services, the treatment prices will be higher. To save some money, patients may want to look for chiropractors further out from their homes. You will also need to take into consideration the travel cost for each trip.

The location of the chiropractor’s office will also influence the cost of your treatments. Chiropractors can operate from private offices, hospitals or in medical centers. The private office will more than likely have more amenities and equipment for treatments and thus cost more. The clinic or hospital in your local area would most likely cost a bit less.

Does Medicare Advantage Or Medigap Offer Chiropractic Benefits?

Medigap plans do cover chiropractic and acupuncture care. Your Medigap Plan C and plan F both cover 100% of your Part B deductible, as long as the proper chiropractic modifiers are used. Patients would have the 20% covered for their Medicare chiropractic coverage paid. Medically necessary services done by a chiropractor are completely covered when the patient has Medigap plans.

Medigap is a lot different than Medicare. Medicare gives the patient a good start, but there are gaps that the patient needs to cover for complete care. The gaps could cost a patient a lot of money. Benefits from Medicare do not begin until the deductibles are paid. Medigap pays those deductibles that Medicare requires. When a patient has medically needed chiropractic care, his or her Medigap insurance will cover the cost that Medicare does not cover.

Some Medicare Advantage plans may cover chiropractic coverage. This plan is something that the patient signs up for and it replaces Medicare Part A and Part B. It will depend on the company that you have chosen as to whether or not they will cover the 20% deductibles left after Medicare has paid the 80%.