does medicare cover chiropractic care

If you’re one of the millions of Americans relying on Medicare for your healthcare needs, you might be wondering about your options for managing back or neck pain. It’s a common question, especially for those seeking drug-free, hands-on approaches to pain relief. So, let’s clear up the confusion and get a straightforward answer to the question: does medicare cover chiropractic care? The short answer is yes, but with some very specific rules about what is and isn’t covered.

What Medicare Part B Covers for Chiropractic

Medicare Part B provides coverage for chiropractic care, but it’s focused on a very specific type of treatment. The primary service covered is manual manipulation of the spine to correct a subluxation. In simpler terms, this is the hands-on adjustment chiropractors are known for, but Medicare will only pay for it if it’s deemed medically necessary to fix a specific misalignment. This means routine or maintenance adjustments are not covered.

Services That Aren’t Covered by Medicare

It’s just as important to know what isn’t included. Medicare will not pay for other services you might receive during a chiropractic visit, even if they are performed by the same provider. This includes X-rays, massage therapy, acupuncture, or orthotics. You will be responsible for 100% of the cost for these additional services. Your chiropractor should provide you with an Advanced Beneficiary Notice (ABN) outlining these costs before providing non-covered services.

Your Out-of-Pocket Costs Explained

For the covered spinal manipulation, you are responsible for your Medicare Part B deductible and coinsurance. After you meet your yearly Part B deductible, you typically pay 20% of the Medicare-approved amount for the adjustment. Your chiropractor must also accept Medicare assignment, meaning they agree to charge only the Medicare-approved price. If they don’t, you could end up paying more.

Making the Most of Your Chiropractic Benefits

To ensure your visits are covered, always confirm that your chiropractor is enrolled in Medicare and accepts assignment. The treatment must also be documented as medically necessary in your medical records. It’s a good practice to talk with your primary care doctor about your pain and ask if a chiropractic referral is appropriate for your condition.

Navigating healthcare coverage can feel complex, but knowing the rules for chiropractic care under Medicare empowers you to make informed decisions. By understanding what services are covered and what your financial responsibility will be, you can seek the pain relief you need while avoiding unexpected bills.