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Does Medicare cover chiropractic services?

En español | Yes, but coverage is limited.

Medicare Part B covers services from a licensed chiropractor under one circumstance: the manual manipulation, also called an adjustment, of the spine when it’s considered medically necessary to correct a subluxation. This spinal misalignment occurs when one or more bones in your back are out of position.

Part B covers treatment for an acute or chronic spinal condition that a chiropractor or other qualified provider performs on an outpatient basis. What won’t be covered is continuing chiropractic care, called maintenance care, after the spine has been realigned.

Acute conditions generally develop suddenly and last for a short time. Chronic conditions develop slowly and can get worse over time.

How much does a chiropractic visit cost under Medicare?

If you’ve already paid your annual Part B deductible, which is $233 in 2022 (and $226 in 2023), you pay 20 percent of the cost of a Medicare-approved chiropractor visit. If you have a private Medicare supplement policy, also known as Medigap, that policy will cover all or part of the 20 percent Part B coinsurance cost.

What chiropractic services doesn’t Medicare cover?

Medicare has no limit to the number of chiropractic visits covered but, again, it covers only medically necessary spinal manipulation to correct the subluxation. It won’t cover regular maintenance or preventive chiropractic visits or chiropractic treatments to other parts of the body.

Medicare will cover the cost of a physician-ordered X-ray that’s needed to validate that a spinal subluxation requires treatment, not any X-ray that a chiropractor orders. That’s a key difference to be aware of. If a chiropractor orders, takes or interprets an X-ray or another diagnostic test, Medicare will not provide coverage for those services.

In addition, Medicare doesn’t cover other services or tests that a chiropractor orders, such as massage therapy and acupuncture — unless the acupuncture is for treatment of chronic low back pain.

Does Medicare Advantage cover chiropractic services?

If you have a private Medicare Advantage plan rather than original Medicare, you may get extra coverage for chiropractic services. Medicare Advantage plans must cover at least the same chiropractic services as original Medicare, but copayments and deductibles may vary.

Be prepared: You might have a $20 or $30 copayment for each chiropractic visit. And the Medicare Advantage plan may require you to use an in-network provider.

Some Medicare Advantage plans cover routine chiropractic visits as an additional benefit. To find plans in your area that cover extra chiropractic services, use the Medicare Plan Finder to get a list of plans in your zip code.

Within each result, click on the Plan Details button and scroll down to the dark blue bar to click on + View more benefits & costs. Scroll down further to + View more extra benefits.

You’ll see chiropractic services in the list of Medically approved non-opioid pain management servicesSome coverage or Not covered will be noted in the box. You’ll need to contact the plan or visit its website for more details.

Keep in mind

If you have a health savings account, you can withdraw money tax-free from the HSA to pay out-of-pocket costs for medically necessary chiropractic care. You can’t contribute to an HSA while enrolled in Medicare, but you can use money you already have in the account at any age.

Updated October 4, 2022

     

        


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