Does Medicare Cover Chiropractic Care?

Receiving regular chiropractic adjustments can be integral to the long-term treatment of chronic musculoskeletal pain, particularly that in the back, neck and joints. Chiropractic care may be used either alone or in tandem with other kinds of medical treatment, and does not involve the use of drugs. As with any kind of regular medical care, the cost can be an issue if it is not covered by insurance, especially if you are on a limited income. So you may want to know if Medicare covers chiropractic care.

In short, some limited chiropractic treatment is covered by Medicare Part B. This includes only manual manipulation and manipulation with the use of a hand-held device in order to correct a spinal subluxation (a condition in which the bones of the vertebrae are out of alignment); however, it does not cover initial physical exams, diagnostic services, x-rays, acupuncture, physical therapy, nutritional supplements, orthopedic devices or chiropractic treatment for anything other than spinal subluxation.

Medicare will cover chiropractic treatment if you fall into one of the following categories: 1) You have a significant neuromusculoskeletal condition requiring treatment, such as pain, swelling, inflammation, numbness in the limbs, etc.; 2) You have a spinal subluxation; or 3) A referring medical doctor has recommended manual manipulation to improve your condition.

The cost to you will include what you first have to pay to cover the Part B deductible, then 20% of the cost of the Medicare-approved chiropractic services. You are responsible for covering the fees for any additional chiropractic services not approved by Medicare. Chiropractic visits are limited to one per day, unless it is deemed medically necessary to have them more often, and coverage lasts as long as there is improvement. If chiropractic treatment reaches a plateau where no further improvement can be seen, then Medicare coverage ends.

If you intend to use Medicare to cover your chiropractic services, first check to be sure your chosen chiropractor participates in Medicare. If so, ask the provider if they accept assignment (meaning they are paid by Medicare, not by you, apart from the amount of your deductible and co-payment), which reduces your out-of-pocket expenses, what they charge and how much of that amount you will be responsible for. If the chiropractor does not accept assignment, you may need to pay for the treatment entirely out of pocket, bill Medicare yourself and wait a number of weeks for payment.

If your chiropractor does not participate in Medicare, Medicare will not pay for treatment. If, however, you are covered by a Medigap/Medicare Supplemental Plan, you may pay little or nothing for chiropractic treatment. Ask your plan manager about the amount of coverage you may have.

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