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Does Medicare cover chiropractic services?

Category: General Medicare
Updated: Jul, 09 2023


Yes, in some situations, limited chiropractic services are covered by Medicare.

According to the Medicare.gov website, your "Medicare Part B (Medical Insurance) covers manual manipulation of the spine if medically necessary to correct a Subluxation when provided by a chiropractor or other qualified provider."

However, Medicare also noted that there is not Part B coverage for "other services or tests ordered by a chiropractor, including X-rays, massage therapy, and acupuncture."

Medicare defines "medically necessary" as: "Health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine."

As reference, please see:
https://www.medicare.gov/coverage/chiropractic-services

Question:  What will I pay for covered chiropractic services?

For approved chiropractic services, Medicare notes that you will "pay 20% of the Medicare-approved amount and the Part B Deductible applies."

To learn more, you can also speak with a Medicare representative by calling toll-free 1-800-633-4227 (1-800-Medicare).


Medicare Advantage plans and supplemental Chiropractic Coverage

Some Medicare Advantage plans (MAs and MAPDs) provide additional chiropractic coverage.  The chiropractic services may be offered from your Medicare Advantage plan as an supplemental package or "coverage bundle" for additional cost.

To learn more about your Medicare Advantage plan coverage, you can contact your plan using the toll-free Member Services number found on your Member ID card or you can review your plan's Evidence of Coverage document where you can find information such as:

"Chiropractic services

Covered services include: We cover only manual manipulation of the spine to correct subluxation. Prior authorization may be required and is the responsibility of your provider.

What you must pay when you get these services in-network:  $20 copay for each Medicare-covered chiropractic visit.

What you must pay when you get these services out-of-network:  After you pay your $500 deductible, you pay 50% coinsurance for each Medicare-covered chiropractic visit."

Medicaid and Chiropractic Service Coverage

Depending on where you live, state Medicaid programs also provide chiropractic coverage.  If you are eligible for Medicaid, you can contact or visit your local state Medicaid office for more information about chiropractic coverage.

Here is the Medicare link that will help you find your state Medicaid office:
www.medicare.gov/talk-to-someone





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