Medicare coverage for chiropractic services is more limited than many beneficiaries expect. Let’s explore what’s covered, what isn’t, and how to navigate these benefits.
What Medicare Covers
Medicare Part B covers chiropractic services for manual manipulation of the spine if it is deemed medically necessary to correct a “subluxation” (when a joint in your spine needs more movement). Medicare does not cover other services or tests ordered by a chiropractor, such as exams, soft tissue manipulation, extremity (shoulder, hip, knee, etc.) adjustments, or rehabilitative exercises.
At our office, we ensure that we follow all Medicare guidelines and only bill Medicare for services that are covered under your benefits. However, it’s important to note that since Medicare does not cover all chiropractic services you may need or desire, you will be responsible for some out-of-pocket costs.
Medicare Advantage Plans
Some Medicare Advantage plans offer additional chiropractic benefits beyond Original Medicare coverage. Check your plan’s specific benefits, as coverage can vary significantly between different insurance providers. Pinnacle Hill Chiropractic’s Billing & Insurance Coordinator, Jen would be happy to do this for you if you call the office and provide her with the necessary information.
Our Billing Practices
We strive to be fully transparent in our billing procedures and work closely with Medicare to ensure all claims are processed correctly. We want to emphasize that our office cannot be held responsible for how other chiropractic offices may choose to handle their billing practices. Each provider may have their own approach, and it’s possible that some services could be billed differently elsewhere.
If you have any questions about the specifics of your treatment, please discuss this with your chiropractor. If you need help deciding the provider on our team that is the best fit for you, visit our website and read about us here!
Advocating for Change
If you feel that the current Medicare guidelines for chiropractic care do not meet your needs, we encourage you to take action. By reaching out to your federal representatives, you can voice your concerns and advocate for change. This is a powerful way to potentially expand coverage and influence future healthcare policies.
Currently, Representative Joseph Morelle (NY-25) is a co-sponsor for this bill but neither NY Senators have shown their support. You can send them both a pre-written letter asking for their support in this matter, you can do so here.
We are here to help and answer any questions you may have about your Medicare coverage or chiropractic care in general. Your health and satisfaction are our top priorities.
