(800) 973-1540

Does medicare cover Chiropractic care and services?

4 answers | Last updated: Oct 08, 2014
rgreenruth asked...
Does Medicare cover chiropractic care and services?
 

Answers
Caring.com User - Joseph L.  Matthews
Caring.com Expert
A
Joseph L. Matthews is a Caring.com Expert, an attorney, and the author of Long-Term Care: How to Plan & Pay for It and...
37% helpful
answered...

See also:
What kind of financial aid programs are available to full-time caregivers?
Mostly no, but Medicare Part B can cover some chiropractic care in certain, very limited circumstances. The only chiropractic treatment Medicare Part B covers is manipulation of the spine to correct a subluxation (a bone in your spine out of position). The treatment must be considered medically necessary, and formally prescribed, by a physician. In other words, for Medicare to cover the treatment, it can't be a chiropractor alone who decides that you need it. Also, the care must be provided by a Medicare-certified chiropractor. If Medicare Part B covers the treatment, as with most other medical bills it will pay 80 percent of the Medicare-approved amount, leaving you (or your Medigap insurance) to pay the remaining 20 percent.

If you are enrolled in a Medicare Part C Medicare Advantage managed care plan, your plan may cover slightly broader chiropractic treatment than traditional Medicare Part B does. Check with your plan directly, or ask your chiropractor's office to check, to find out if there is any broader coverage and what its terms are.

 

More Answers
64px-hh6b80fd52d1
17% helpful
An anonymous caregiver answered...

Most of the original answer to this question was correct. However, I would like to clarify three points:

1) Medicare does not require a referral for chiropractic care. Chiropractic physicians are qualified to determine your need for treatment according to Medicare. 2) Medicare does require a chiropractic examination to determine if chiropractic care is appropriate. Medicare does not cover the cost of this examination. If treatment is appropriate, Medicare pays 80% of the treatment costs. 3) Many people seek chiropractic care for conditions related to joints outside of the spinal column (knees, hips, shoulders). These conditions are not covered by Medicare. Only spinal conditions are covered.

I hope this information is helpful.

 

RebeccaW answered...

This answer is very misleading. Medicare does cover manipulation of the spine to correct a subluxation. That is what chiropractic manipulation does...correct subluxations. Chiropractors must prove the existence of a subluxation through exam or x-ray, neither of which is a covered service, to qualify for payment of the treatment. For most patients seeking chiropractic care, they pay out of pocket for the exam and/or x-rays and then Medicare pays 80% of the manipulative treatment as long as it is treatment of the spine and not an extremity.

 

64px-hh6b80fd52d1
An anonymous caregiver answered...

Go to medicare.com or cms.gov in their search site type in Chiropractic. You will find that "In many cases a chiropractor may be the primary method of treatment" Medicare will NOT cover Initial Exams, evaluation services, X-rays, Acupuncture, Physical Therapy, Supplements, orthopedic devices. You will have to have a significant health problem in the form of a neuromusculoskeltel condition such as back pain, neck pain swelling of legs, numbness of those extremities or feet, or subluxation of the spine numbness. of those extremities.

 

 
Ask a question Ask a question | Add an answer Add an answer