chiropractic care and insurance

 

31 million Americans experience lower back pain from time to time.

While back pain seems harmless on the surface, the reality is rather different.
Back pain is the leading cause of disability. It’s also among the top reasons why people miss work, making it culpable for lessened productivity in the workplace.

If anything, these facts underscore the need to have back pain checked out in a timely manner, and by the right professional to treat the underlying issue to fix the problem instead of masking it with medication. This is where a Chiropractor comes in.

For most people, the next question becomes a matter of cost.

Is chiropractic care covered by insurance? This article will detail on chiropractic care and everything you need to know about insurance coverage.

What Do Chiropractors Do?

Chiropractors treat a range of conditions that help improve posture, ease uncomfortable symptoms, and enhance your overall wellbeing.

Chiropractors use hands-on spinal manipulation and other therapies to alleviate pain.

The theory behind this is that proper alignment of the body’s musculoskeletal structure enables the body to heal itself without medication or surgery.

Manipulation can also be used to restore mobility or restricted joint movement caused by trauma or stress.

Is Chiropractic Care Covered by Insurance?

The short answer is yes.

While widely considered to be alternative medicine, most insurance companies cover it.

Chiropractic care is included in most health insurance plans. It’s also included in larger health plans such as workman’s compensation.

Medicare, some Medicaid plans and companies like Blue Cross Blue Shield, Aetna, United Healthcare, and Cigna also provide this coverage. Treatment parameters vary and depends on your specific benefit type.

Here are the four main insurers and their coverage of Chiropractic treatment.

Blue Cross Blue Shield Coverage

Blue Cross Blue Shield Insurance offers robust chiropractor care coverage for its clients.

For Chiropractic care to be considered for coverage, a patient’s case must:

1. Meet the medical criteria as follows:

The service provided must be geared towards diagnosis or treatment of a medical condition, injury, illness or disease
It must be necessary for treatment, cure or relief of symptoms
The treatment must meet generally accepted standards of care
This means that a relaxation massage may not be covered by your insurer.

2. The patient must have symptoms that can be alleviated by chiropractic treatment.

3. There is a clear care plan detailing:

A clear diagnosis
A treatment plan detailing symptoms
A clear outline of diagnostic procedures and treatment modalities
Anticipated length of treatment
Long and short term treatment goals

Make sure that these are well documented to avoid any misunderstandings with your insurer.

4. Chiropractic care is performed by a licensed professional.

Aetna Coverage

Aetna also covers Chiropractic care, within certain parameters.
Aetna considers chiropractic services as medical treatments when they fall within the following threshold:

The patient has a neuromusculoskeletal disorder
The medical necessity is clearly outlined and documented
There is documented improvement within the first two weeks of initiating treatment

With no notable improvement in two weeks, a treatment is considered non-medical, unless a patient takes on different Chiropractic treatment.

Also, treatment in persons that are not improving or regressing is not considered as medically necessary. This means it does not get covered.

If at this point, a patient feels the need to continue their chiropractic sessions, the only option is to pay for them in cash.

Cigna Coverage

Cigna will cover Chiropractic manipulation under the following criteria:

Care is performed by a licensed chiropractor
A neuromusculoskeletal condition is diagnosed, with expected good outcomes from chiropractic therapy
The patient has a clear outline of the prescribed treatment, symptoms, diagnostic procedures and results
A patient documents the frequency, duration and results of planned treatments
There is information on the anticipated length of treatment with quantifiable long and short term goals

United Healthcare Coverage

United Healthcare will cover Chiropractic manipulation under the following criteria:

Care is performed by a licensed chiropractor
A neuromusculoskeletal condition is diagnosed, with expected good outcomes from chiropractic therapy
The patient has a clear outline of the prescribed treatment, symptoms, diagnostic procedures and results
A patient documents the frequency, duration and results of planned treatments
There is information on the anticipated length of treatment with quantifiable long and short term goals

Chiropractic Services Without Insurance

The patient might be obligated to pay out of pocket for several reasons. One is a lack of insurance or being insured by a company that exempts chiropractic treatment.

The second is where a patient gets some relief from the treatment, but their insurer does not meet their insurer’s regulations of what constitutes an insurable chiropractic treatment.

Your Chiropractor should help explore both options of utilizing your insurance or going the cash route to see what best fits your circumstances.

Either way, whether you pay in cash or using your insurance, chiropractic therapy can slow down certain conditions.

This prevents them from spiraling into a more serious health concern that might result in expensive treatments such as surgery.

How Do I Find the Best Chiropractor near Me?

When you work on a treatment payment plan, either via insurance or cash, your next step is to find the best chiropractor in your area

Here are tips to do that:

Get Referrals

This allows you to get a tried and tested professional. Ask within your social circles and see if you can find recommendations to a reputable chiropractor.

Scout the Internet

Carry out a generic Google search on Chiropractor services to find a few suggestions in your area.

You might want to include your location, and payment terms. For example, if you are using Blue Cross Blue Shield Insurance, you can search this as “Houston Chiropractor using Blue Cross Blue Shield Insurance’.

Similarly, search ‘’chiropractor near me no insurance’’ if you are a cash payer.

Check Coverage Policy

When you settle on a Chiropractor and are using insurance, check if your insurance covers Chiropractic treatments.

Countercheck the specifics of what is covered, the amounts and if your preferred chiropractor is a listed service provider.

Your Insurance Provider can also provide you a list of all in-network providers in your area.

Meet and Greet

Most providers will be happy to schedule you for a meet and greet. You should not expect a full evaluation here. This is just an opportunity for you to see the facilities and ask any questions you might have.

You will also use this opportunity to gauge the doctor’s responsiveness and demeanor to see if they would be a good fit.

Need Treatment?

So, is Chiropractic care covered by insurance? Indeed it is, within certain limitations.

If you feel you need Chiropractic care, scrutinizing your insurance policy is a great place to start in assessing your treatment options.

Elite Spine has been voted one of the Best Chiropractors in Houston and Spring. Our clients appreciate our relaxed, personalized approach to treatments.

Schedule an appointment today, and let’s work on a recovery plan together.

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