What You Need To Know About Medicare Coverage For Chiropractic Services
Today’s Medicare program includes several parts, each with different coverage options. As a Medicare beneficiary, you are probably familiar with Part A (hospitalization, inpatient care), Part B (outpatient, fee-for-service), Part C (Medicare Advantage plans such as HMOs, PPOs, special needs plans, and private-fee-for-service plans), and Part D (the stand-alone prescription drug plan).
Understanding the Prescription Drug Benefit’s Impact on Chiropractic Coverage
Decisions regarding the prescription drug benefit can affect your chiropractic coverage. In 2003, Congress passed the prescription drug benefit, allowing beneficiaries to access it in two main ways:
- Part D Plan: By subscribing to a stand-alone prescription drug plan.
- Part C (Medicare Advantage Plan): By joining a Medicare Advantage plan, which often includes prescription drug coverage along with medical services.
Each year, beneficiaries can choose to switch their Medicare coverage during the enrollment period. However, joining a Part C plan significantly alters how Medicare-guaranteed services, including chiropractic care, are administered.
Does Part C Medicare Advantage Plan Cover Chiropractic?
Historically, Medicare Advantage plans (especially HMOs) have not consistently provided chiropractic services. Before enrolling in any Part C plan, it is essential to ask the following questions:
- Does the plan include doctors of chiropractic in its network? Many Medicare Advantage plans claim to offer chiropractic services but may only offer access to non-chiropractic providers or rarely provide actual chiropractic care.
- Is your preferred chiropractor from Cole Pain Therapy Group included in the network? Confirm that your chiropractic care provider is part of the plan’s network.
- What are the statistics regarding chiropractic services within the plan? Inquire about the number of plan participants who receive chiropractic care and the average length of treatment. Chiropractic care often requires ongoing treatment, so limitations on service duration or frequency can be problematic.
- What is the co-pay for chiropractic visits? In many Medicare Advantage plans, chiropractors are classified as specialists, which could mean a co-pay of $30 or more per visit. This is a significant change for those who are accustomed to receiving chiropractic care under Medicare Part B, where co-pays may be lower or nonexistent.
Medicare Beneficiaries’ Right to Chiropractic Care
Medicare beneficiaries are entitled to receive chiropractic care, so it’s important to thoroughly evaluate any Medicare Advantage plan before enrolling. Consider the questions above and ensure you are making an informed decision about your healthcare coverage.
Be informed of your rights. Contact the American Chiropractic Association for more information at 703/276-8800.
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We are the Memphis area’s top-rated chiropractic group, providing you with gentle chiropractic care, dry needle therapy, exercise therapy, and therapeutic massage.
2845 Summer Oaks Dr, Memphis, TN 38134
(901) 377-2340
Life Shouldn't Hurt!
You Deserve To Feel Great. We Can Help!
Your go-to Chiropractor in Memphis, TN
Richard L. Cole, DC, DACNB, DAIPM, FIACN, FICC
Jeffrey D. Luebbe, DC, CCRD, CCSP
W. Steven Vollmer, DC, DAAPM
Bradford J. Cole, DC, MS, CSCS
J. Colby Poston, DC
Daniel H. Smith, DC
2845 Summer Oaks Dr., Memphis, TN 38134
(901) 377-2340
Monday – Friday:
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Saturday :
8:00 AM – 12:00 PM
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