Medicare is a federal health insurance program for people aged 65 years and older. Several different parts are available. Medicare does cover some aspects of chiropractic care, including spinal manipulations for back pain.
According to the American Chiropractic Association, around 80% of people experience back pain at some point in their lives.
People use chiropractic treatments to help relieve musculoskeletal problems, including back, neck, and joint pain. Trained chiropractors can also treat some headaches.
Although chiropractic treatment may be effective for relieving specific pains, some chiropractors have made unsubstantiated claims about the benefits of the practice for non-musculoskeletal conditions. However, a 2016 article set out a list of ways to improve the scientific standing of chiropractic treatment.
Most chiropractors have since abandoned the idea that spinal manipulation can help treat conditions with no link to the spine.
This article explains which chiropractic services Medicare covers, as well as some other Medicare-funded treatments for back pain.
Medicare covers chiropractic manipulation of the spine to help a person manage back pain.
A person must have active back pain to qualify for Medicare reimbursement. A chiropractor cannot provide spinal manipulations as a maintenance or preventive service. Medicare will only fund chiropractic care that corrects an existing problem.
Although Medicare will pay for certain chiropractic services, it does not cover massage therapy or X-rays.
If a chiropractor offers or recommends any of these services, a person should ask about the cost of each, as they will need to fund the treatment themselves. That said, Medicare will pay for a physician to perform an X-ray. This could indicate that a referral to a chiropractor is medically necessary.
Medicare Part B covers some aspects of chiropractic care. Part B is the portion that helps people pay for doctors’ visits and some related treatments.
Once a person meets their yearly deductible, Medicare will usually fund 80% of the cost for chiropractic treatment.
Medicare Advantage, or Medicare Part C, is an alternative to traditional Medicare. Private health insurance companies offer these plans. Some plans may include greater coverage for chiropractic treatments than others.
However, the level of coverage depends on the plans available in a person’s geographical area.
A person with Medicare Advantage may also be part of a plan called a health maintenance organization or a preferred provider organization. These plans require the selection of an in-network healthcare provider to receive full reimbursement.
A person may need to check that a chiropractor is in their network before seeking treatment with them.
Medicare supplement, or Medigap, plans may also cover copayments for chiropractic care. People with traditional Medicare may purchase these plans, while those with Medicare Advantage cannot.
In the United States, chiropractors see an estimated 35 million people every year, according to the American Chiropractic Association. Chiropractic care serves as an alternative to other treatment options for pain and discomfort, such as surgery or pain medications.
Some conditions a chiropractor can treat include the following:
- back pain
- conditions affecting the joints, ligaments, and muscles
- neck pain
In addition to these services, a chiropractor may offer wellness services. Examples include diet, exercise, and nutrition.
Doctors can treat back pain with various medical treatments and some alternative therapies. These include:
- Acupuncture: Acupuncture refers to the insertion of small, thin needles into the body to restore energy flow and reduce pain. In January 2020, the Centers for Medicare & Medicaid Services announced that Medicare would cover acupuncture to treat chronic low back pain. Medicare will cover up to 12 sessions over 90 days, with a potential eight additional sessions if symptoms are improving.
- Massage: Medicare does not currently cover massage therapy services. A person is responsible for 100% of the costs for massage therapy for back pain.
- Physical therapy: Physical therapy involves the use of exercises to strengthen and stretch the back and treat back pain. Medicare Part B covers any physical therapy service a doctor recommends to treat back pain. A person is responsible for 20% of the Medicare-approved amount up to their deductible for treatments.
It is important to note that coverage for Medicare changes frequently and often expands to include more treatments. The Medicare website has a useful tool that people can use to search for a particular service to determine whether or not Medicare covers it.
Chiropractic care can help reduce symptoms in some people who experience back pain. Medicare will cover the treatments if a person has active back pain and shows improvement over time.
If a person has a Medicare Advantage plan, they may require a referral from a doctor. Alternatively, they may need to select an in-network doctor to receive treatments.
As of January 2020, Medicare funds up to 12 sessions of acupuncture, with the option to extend the course of treatment by eight sessions if the treatment is successfully reducing back pain.
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