Q. When is chiropractic care covered by my health insurance plan?
A. Chiropractic care is covered by your health insurance plan if it is for acute (short-term) care such as for a recent injury, or for a condition where treatment offers lasting benefit or curative value.
Q. Is there a certain amount of treatment thats covered?
A. For most plans, the amount or length of treatment thats covered by insurance is not necessary denied by the number of visits or type of treatment. Rather, the treatment is covered as long as it demonstrates significant, lasting, or progressive improvement to your condition.
Q. When is chiropractic care not covered by my health insurance plan?
A. Chiropractic care is NOT covered by your health insurance plan when you reach a point in treatment when chronic symptoms remain stable or when you no longer so progress in reducing these chronic symptoms through chiropractic care. At this point, you have reached what is called "maintenance" care. Note: Medicare and Medicaid cover ONLY spinal. they do not Cover extremities such as knees, wrist, etc.
Q. How will I know if I have reached the end of covered care?
A. Your chiropractic provider will let you know when you have reached a point of "maintenance" care and will discuss further care options.
Q. What happens when am determined to have reached the end of covered treatment but still want to have regular chiropractic adjustments?
A. you may continue maintenance treatment, you must pay for it completely out of pocket. If you choose to receive chiropractic care beyond acute care, it is a cash service where you will be responsible for the payment.
Q. How will I know the cost to me of maintenance care?
A. Prior to receiving maintenance care, your provider will have you sign a Financial Discloser Form, letting you know in advance the costs of the elected services.
Q. Is it possible to move from maintenance care back to chiropractic care covered by my insurance plan?
A. If you sustain a future incident or injury, you chiropractic care would again meet the criteria for acute care and would be covered by your health plan, until that condition has reached a plateau level and does not provide any more lasting, curative value.
Q. Who should i contact with questions?
A. Please contact the billing office for any specific questions regarding your benefit coverage.
INSURANCE FOR BACK AND NECK TREATMENTS
Insurance coverage for chiropractic care can depend on a variety of factors. Most plans cover cost of chiropractic care for acute (short-term) conditions or flare ups of chronic pain. However, many patients often have a co-pay at the time of their visit.
When longer term care is needed for conditions that are chronic, severe, or occur in conjunction with another health problem, be sure to talk with your health insurance company to determine your benefits. Most cover initial and some rehabilitative care for acute conditions, but many do not cover maintenance or wellness treatment.
THREE STEPS OF CHIROPRACTIC CARE
Step 1 - Relieve: Initially the goals are to relieve your symptoms while improving function and mobility.
Step 2 - Reduce & Rehabilitate: Once your initial symptoms have been relieved, the next Step is to reduce the remaining chiropractic subluxations and rehabilitate weak muscles and faulty movement patters caused by the symptoms-pain present in Step 1 thus reducing the chance of flare ups.
Step 3 - Restore: Restore structural integrity-balance (posture and alignment) while symptoms are gone or minimal so as to maintain function, health and wellness with an emphasis on prevention.
Overall, costs for patients receiving care for back pain have been reported as lower for those who receive treatment from chiropractor. Chiropractic care has become a well accepted treatment for acute and chronic pain and problems of the spine, yet chiropractic care can be effective for many other orthopedic condition including (but not limited to); shoulder pain, rotator cuff injury/pain, arthritis of the knees and hips, elbow and wrist pain, tendonitis, ankle and foot pain as well as other non-surgical bone, joint and soft issue condition.