Medicare's Coverage of Chiropractic Services
Medicare Part B covers specific chiropractic services:
Manual Manipulation of the Spine
Medical Necessity: The chiropractic treatment must be considered medically necessary.
Subluxation Diagnosis: The chiropractor must document a subluxation diagnosed through X-rays or a physical exam.
Acute or Chronic Pain: The treatment must be for acute or chronic pain.
Maintenance Care: Medicare does not cover maintenance chiropractic care.
Part B Deductible: You must meet your annual Part B deductible before Medicare starts paying.
Coinsurance: Medicare typically pays 80% of the Medicare-approved amount. You pay the remaining 20%.
Non-Covered Services: Medicare does not cover X-rays, exams, or other diagnostic tests performed by a chiropractor.
Potential Out-of-Pocket Costs
Even with Medicare coverage, you may have some out-of-pocket expenses:
Part B Deductible: As mentioned, you must meet this first.
20% Coinsurance: You'll be responsible for this portion of the Medicare-approved amount.
Non-Covered Services: You'll pay 100% for services not covered by Medicare.
To ensure you get proper coverage:
Doctor's Documentation: Ensure your chiropractor thoroughly documents your medical need for manipulation.
Medicare-Approved Chiropractor: Choose a chiropractor who accepts Medicare assignment.
Understand Limitations: Understand what services are and are not covered by Medicare.
Keep Records: Keep records of your medical documentation and chiropractor invoices.
Medicare covers chiropractic spinal manipulation when medically necessary, providing relief for those with subluxations. Understanding the coverage details and potential costs can help you navigate this aspect of your healthcare. For more insight into how this concept interacts with others, see our detailed guide on Medicare Part B, which further explores the overall structure of Medicare's outpatient medical insurance and its implications in greater depth.
