by Russell Noga | Updated May 12th, 2023
If you’re dealing with back pain, a session with the chiropractor offers you relief. These individuals manipulate the spine, neck, and hips, realigning your vertebrae to release tension. Chiropractic is a pseudoscience, but the millions of people that use these services would say otherwise, swearing by the practice.
The cost of a chiropractic session can be as much as $50 or more, and that’s a huge expense for seniors living on a fixed income. Shelling out $50+ every few months to relieve your back pain and keep your spine healthy isn’t feasible for many Americans. However, without these services, seniors lose mobility and significantly reduce their quality of life.
Does Medicare or Medicare supplement Plans cover chiropractic expenses? Or will you need to pay them out-of-pocket?
Keep reading to learn about the coverage you have for chiropractic services.
When did Medicare Start Covering Visits to the Chiropractor?
President Richard Nixon signed Public Law 92–603 into legislation in 1972. The law added coverage for chiropractic treatments into Original Medicare benefits for beneficiaries. The ruling resulted from an intense lobbying campaign lasting seven years since the launch of Medicare in 1965.
In recent years, the Medicare industry and practitioners have shown interest in expanding the scope of chiropractic services and other therapies, like acupuncture, in Medicare benefits.
Integrating these services into Medicare benefits aims to reduce seniors’ dependence on opioid medications to assist them with pain relief.
How Many Visits to the Chiropractor Does Medicare Permit?
There are no limitations on the chiropractic treatments available to Medicare beneficiaries. However, to be eligible for coverage, the adjustment must serve the purpose of realigning altered vertebrae. Medicare and Medigap won’t cover beneficiaries for chiropractic sessions used as preventative care strategies.
For instance, if you have a car accident and experience an injury requiring chiropractic alignment, you have coverage for the adjustment. However, if you have a healthy back and want a routine adjustment to stay mobile and flexible, Medicare and Medigap won’t cover the costs of the adjustment.
Medicare also does not cover items that a chripractor orders, such as x-rays, acupuncture (unless it’s for chronic low back pain), or massage therapy.
What Does Medicare Pay for Chiropractic Adjustments?
Original Medicare Part B covers 80% of the cost of Medicare-approved chiropractic adjustments. The beneficiary’s financial obligation is the remaining 20%. Usually, that’s between $6 to $10 after you reach your annual Part B deductible of $226 for 2023.
A Medigap supplemental insurance plan might cover the additional 20% remaining in your financial responsibility, reducing out-of-pocket costs to $0.
Medicare Part B Chiropractic Exclusions & Guidelines
Original Medicare Part B only pays for medically-necessary chiropractic adjustments, as in the abovementioned example.
Beneficiaries must visit with their general practitioner to determine if they have a subluxation (misalignment of the spine) and require chiropractic treatment to resolve the issue.
Part B Requirements for Chiropractic Coverage
- The adjustment must be medically necessary and determined by a doctor via examination or X-ray.
- It only covers adjustments for altered vertebrae (subluxation).
- Must address specific problems, not for maintenance or preventive care.
- Unlimited treatments for medically necessary cases.
Exclusions for Chiropractic Coverage
- Doesn’t cover ultrasound treatments, massage therapy, or traction therapies.
- Doesn’t cover diagnostic tests or X-rays at the chiropractor.
- These tests may demonstrate medical necessity for chiropractic sessions but require doctor approval for coverage.
How Much Does Chiropractic Care Cost with Part B?
As mentioned, you’ll pay between $6 to $10 per adjustment as your 20% out-of-pocket cost for the remaining expense not covered by Original Medicare Part B.
Beneficiaries must use a chiropractor charging Medicare-approved rates to qualify for coverage.
The cost of chiropractic treatments depends on the number of spinal regions requiring adjustment.
Procedure Cost for the Procedure Your Financial Liability
1 to 2 regions of the spine $28 $6
3 to 4 regions of the spine $40 $8
5 regions of the spine $52 $10
Before undergoing chiropractic treatments, beneficiaries should seek medical advice from their doctor regarding the best treatment to resolve their unique condition.
In some cases, chiropractic might not be the best option, especially if you’re dealing with the advanced stages of spinal stenosis or degenerative spondylolisthesis. In these instances, the spine is too weak to handle the manipulation of vertebrae.
What Are the Benefits & Coverage Available in Medigap Plans?
Medigap plans help Original Medicare beneficiaries cope with the remaining 20% of healthcare costs not covered by Parts A & B. There are ten Medigap plans (A, B, C, D, F, G, K, L, M, & N). Each plan offers a different level of coverage for Part A & B expenses.
All Medigap plans offer the following benefits.
- Part A coinsurance and hospital costs for up to 365 days after using up Medicare benefits.
- Part A hospice care coinsurance or copayment.
- Part B coinsurance or copayment.
- Blood transfusion costs for the first three pints of blood.
Plans F, G, and N offer additional Medicare Parts A & B benefits.
- Part A deductible.
- Part B excess charges (Plan N doesn’t cover these charges).
- Skilled nursing facility care coinsurance.
- 80% of emergency healthcare costs when traveling outside the US for 60 days. ($250 deductible and $50,000 maximum apply).
- Unlimited coverage for all out-of-pocket costs.
Does a Medicare Supplement cover Chiropractic in 2024?
Medigap plans will cover the remaining Part B charges if Medicare approves the chiropractic procedure. However, Medigap will not cover preventative treatments or maintenance with chiropractic treatments.
Medicare Supplement Plans in 2024 cover chiropractic just as they have in years past, there are no changes.
If you have a Medigap plan like Plans F, G, or N, you’ll have coverage for the remaining 20% of the costs owed on your adjustment.
All Medigap plans to reduce your Medicare Part B coinsurance by 50% to 100%, depending on the type of plan you have.
Frequently Asked Questions
Does Medicare cover chiropractic services?
Yes, Medicare does cover chiropractic services but only for manual manipulation of the spine to correct a subluxation if medically necessary.
What chiropractic services are covered by Medicare?
Medicare Part B covers only manual manipulation of the spine if deemed medically necessary due to subluxation (displacement). Other chiropractic services such as examinations, X-rays, or additional therapies are typically not covered.
How many chiropractic visits does Medicare cover?
Medicare does not have a set limit on the number of chiropractic visits it will cover. Coverage continues as long as the chiropractic care is considered medically necessary and the treatment plan shows improvement in your condition.
Does Medicare require a referral for chiropractic services?
No, Medicare does not require a referral from your primary care doctor to visit a chiropractor. However, your chiropractor must be Medicare-certified to get coverage.
Do I have to pay for chiropractic services under Medicare?
Yes, you are typically responsible for 20% of the Medicare-approved amount for the chiropractic services after the Part B deductible has been met.
Does Medicare Advantage cover chiropractic services?
Some Medicare Advantage Plans offer broader coverage and may cover more chiropractic services than Original Medicare. It’s best to check with your plan provider to understand the specific coverage details.
Does Medicare Supplement Plan F cover chiropractic services?
Medicare Plan F pays 100% of the gaps in Medicare, but it works just like any other Medigap plan when it comes to chiropractic services being covered. Medicare must pay first, regardless of which supplement plan you have.
Is chiropractic care covered under Medicare Part A?
No, chiropractic care is not covered under Medicare Part A. It is covered under Medicare Part B as it’s considered an outpatient service.
Can I get coverage for chiropractic services through Medigap?
Yes, a Medigap policy can help pay your share (coinsurance, copayments, or deductibles) of the costs of Medicare-covered chiropractic services.
Does Medicare cover chiropractic services for conditions other than subluxation?
No, Medicare only covers chiropractic care for manual manipulation of the spine to correct a subluxation.
How do I find a chiropractor who accepts Medicare?
You can use the Physician Compare tool on the official Medicare website to find chiropractors in your area who accept Medicare.
Contact Our Team for a Free Consultation & Quote on Medigap Plans
If you want more information on Medigap plans and coverage for chiropractic expenses, call us at 1-888-891-0229. Our team of fully licensed Medigap agents has the answers you’re looking for.
We offer a free consultation on Medigap policies and a complimentary quote for the best rates from leading healthcare insurers.
Russell Noga is the CEO of Medisupps.com, an online Medicare Agency and resource center helping Medicare beneficiaries learn about Medicare, Medigap and Part D drug plans, and Medicare Advantage plans since 2009. Russell is licensed in all 50 states and has been featured as a keynote speaker, and author of several publications, along with hosting the very popular Medisupps.com Youtube channel.