Medicare is a federal health insurance program for people aged 65 years and older. Several different parts of the program are available to cover various healthcare treatments and services. 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.
Although chiropractic treatment may be effective for relieving specific pains, some chiropractors have made unsubstantiated claims about the benefits of the practice for nonmusculoskeletal conditions. However, a 2016 article set out a list of ways to improve the scientific standing of this technique.
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, provided they have active back pain. The program only funds chiropractic care that corrects an existing problem and does not cover spinal manipulations as maintenance or preventive services.
Although Medicare will pay for certain chiropractic treatments, 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. However, 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, the portion that helps people pay for doctor visits and some related treatments, covers some aspects of chiropractic care. 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, which private health insurance companies offer. 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 be part of a plan called a health maintenance organization or a preferred provider organization. These plans require the person to use an in-network healthcare provider to receive full reimbursement. Therefore, people should 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. A person with traditional Medicare may purchase these plans, while those with Medicare Advantage cannot.
Chiropractors address a range of spinal and other treatments, and the costs vary according to location, treatment, and the number of sessions.
According to a 2015 review, the cost of chiropractic care per episode ranged from
Medicare may cover other back pain services, medical treatments, and some alternative therapies, including the below.
Acupuncture refers to the practice of inserting tiny 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. The program will cover up to 12 sessions over 90 days, with a potential eight additional sessions if symptoms are improving.
Physical therapy involves using 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.
However, the program does not currently cover massage therapy, so a person is responsible for 100% of the costs of this treatment for back pain.
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 the program provides coverage.
According to the American Chiropractic Association, chiropractors see an estimated 35 million people in the United States every year. 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, which can include diet, exercise, and nutrition interventions.
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 an individual 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 chiropractic 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 successfully reduces back pain.