Back problems can cause chronic pain and discomfort, which tend to worsen as you age. In addition, many people with disabilities have back problems that require chiropractic services for treatment.
So, does Medicare cover these visits to the chiropractor? The answer usually depends on the type of treatment you are receiving. Medicare Part B covers some chiropractic services but not others.
If you are a Medicare beneficiary, keep reading. We will provide all the details you need to know about Medicare coverage of chiropractic services.
Does Medicare Cover Chiropractic Care?
Yes, Medicare Part B covers chiropractic care only under certain circumstances.
- Original Medicare provides coverage for manual manipulation of the spine to correct a spinal subluxation.
This basically means that Medicare will cover the service of a chiropractor manually manipulating your spine to treat back pain. However, there are some conditions.
- The treatment must be medically necessary, and you must have active back pain. Medicare will not pay for preventive chiropractic treatments or maintenance services.
For the treatment to be deemed medically necessary, you must visit your doctor first. If your physician orders a chiropractic visit as part of your treatment, then Medicare will cover the spinal manipulation required for the treatment.
The chiropractor visit might not be covered without this referral from your doctor. If the chiropractor orders additional services, like an X-ray or massage therapy, those extra services are not generally covered by Medicare. We will discuss the exceptions to covered services later in this article.
Some people wonder, “Do chiropractors take insurance?” Not all chiropractors accept insurance, so you should verify with your provider whether they accept insurance before your visit.
KEY TAKEAWAYS
- Medicare Part B covers chiropractic care only under certain circumstances and with a referral from your doctor.
- You must explore Medicare Advantage or private insurance plans if you need additional chiropractic coverage.
- There is no limit to the number of chiropractor visits covered by Medicare, but each treatment must be medically necessary.
Medicare Coverage For Chiropractic Services
So, does Medicare cover chiropractors? You likely already know that there are many parts of Medicare. Each part covers different medical services, so which parts cover chiropractor visits?
Here is what you need to know about how each part of Medicare handles chiropractic services.
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Limitations On Medicare Coverage Of Chiropractic Visits
We’ve already touched on the fact that enrollment in Medicare does not guarantee coverage of all chiropractic services. So, which services are excluded from coverage?
- Any services that are not medically necessary will not be covered. In general, the service must be for treating active back pain. Even manual manipulation of the spine will not be covered if it is done as a preventive measure or maintenance service.
- Similarly, additional services beyond the spinal manipulation the chiropractor might order will not be covered. These services could include ultrasounds, traction therapy, or massage therapy.
- Acupuncture is not typically covered by Medicare, although it can be covered in some cases if it is used to treat chronic low back pain. X-rays or other diagnostic tests ordered by a chiropractor will not be covered, although they might be covered if ordered by a doctor.
- Regarding the frequency of treatments, there is no limit to the number of chiropractor visits that Medicare will cover.
However, each treatment must be medically necessary. The severity of the pain or problem can often significantly impact whether or not subsequent visits continue to be covered by Medicare. As your pain subsides, the treatments will likely become less necessary, and Medicare will likely eventually stop paying for those treatments unless intense pain continues.
TIP
Medicare Part B only provides chiropractic service for the manipulation of the spine to correct a spinal subluxation. You will want to research Medicare Advantage plans for preventative and maintenance chiropractic care.
The Bottom Line
Medicare Part B provides benefits that cover chiropractic services, but only in certain situations. The Medicare options that offer coverage are Medicare Part B, Medicare Advantage, and Medigap.
Part B covers only manual spinal manipulation for active back pain. It does not cover massage therapy or other services ordered by your chiropractor. However, many Medicare Advantage plans provide additional coverage.
You might also use a Medicare supplement plan to help pay for coinsurance amounts and copays not covered under Part B.
Frequently Asked Questions
Medicare will pay for an unlimited number of chiropractic visits, but each visit must be deemed medically necessary.
You can learn more about Medicare chiropractic coverage online. Your Part B coverage will pay for a chiropractor or other qualified provider to manually manipulate your spine to treat a spinal subluxation.
You must have active back pain, as preventive treatments are not covered.
No, Original Medicare does not pay for massages. However, some Medicare Advantage plans might provide coverage for massage therapy in some situations.
Since the coverage details of those plans vary, you would need to check your specific plan to determine whether massage therapy would be covered.
If that coverage is important to you, then you should work with a licensed insurance agent in your local area who can assist with finding a Medicare Advantage plan that will fit your needs.
No, Medicare does not pay for diagnostic tests or exams performed by a chiropractor. The only chiropractic service covered by Medicare is the manual manipulation of the spine to treat active back pain.
The service must be medically necessary, and other services ordered by the chiropractor are generally not covered.
Some Medicare Advantage plans provide this coverage, so you should check your plan details to determine whether your Part C plan would cover a chiropractic exam.
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