Chiropractic care is well-known for being an affordable alternative to surgery and pharmaceutical treatments for muscle and joint pain, tension, stress, and nerve issues. However, it can still make a dent in your bank account, especially if you require long-term treatment.
Luckily, most California insurance providers cover chiropractic treatment either fully or partially. That means, if you are currently suffering from pain or limited mobility, chiropractic treatment may provide significant relief to you at zero cost.
In this article, you’ll learn everything you need to know about insurance coverage for chiropractic care, including a comprehensive list of California insurance companies that cover chiropractic treatments. We also discuss restrictions, deductibles, and ways to get covered even if your insurance company doesn’t want to pay for your care.
Is Chiropractic Care Covered by my Health Insurance?
The short answer is yes, you are likely covered by your insurance for chiropractic care. Even if you weren’t covered in the past, changes in attitudes toward chiropractic care have made coverage more common in California.
Covering chiropractic care can actually benefit insurers (and patients) in the long term because it is considered preventative care. That means, if you let a chiropractor treat your discomfort now, you may avoid more costly and debilitating treatments in the future.
But, that doesn’t mean you can walk into your local chiropractic clinic and expect to be fully covered.
Your insurance coverage may have limits on chiropractic care, so it’s best to call your provider before you schedule an appointment. Be sure to ask how chiropractic treatments are covered by your policy. It’s also common for insurers to cover your chiropractic care but require a co-payment at the office.
If you have a physical or digital copy of your plan, you can easily check to see if chiropractic treatments are covered. Chiropractic care is normally listed under “alternative health care” in your policy.
Does My Insurance Cover Chiropractic Care?
Chiropractic care is covered by most insurance plans. But is it covered by yours? Below, you’ll find a list of California insurers that cover chiropractic care fully or partially.
- Blue Cross Blue Shield
- Cigna
- Humana
- United Healthcare
- Medi-Cal
- Medicare
- Medicaid
Chiropractic care is also covered under workers’ compensation in California. It is included in federal insurance plans, so it’s often covered for members of the armed services, veterans, and federal employees.
However, chiropractic care is not covered by most individual and family ACA plans. This also applies to plans issued by Covered California.
Thanks to extensive coverage by California insurers, it is likely that you can visit a chiropractor with little to no out-of-pocket costs, no matter your financial situation or the quality of your insurance plan. Call your insurer today to ask if chiropractic treatment is included in your plan. Or, contact us at Family Chiropractic. We’re happy to help you better understand your coverage.
Common Health Insurance Restrictions for Chiropractic Care
Your health insurance may not cover all of your chiropractic treatment costs. Or, you may be covered fully only after satisfying certain requirements. Restrictions on chiropractic care can be annoying, but you must meet your insurer’s requirements before you schedule your chiropractic treatment in order to guarantee coverage.
Common restrictions include:
Referrals: You may need a referral from your doctor. This informs your insurance company that your chiropractic treatment is medically necessary.
Caps: Most insurance companies will only cover a certain number of chiropractic visits per month or year.
In-network restrictions: You may be required to choose from a limited list of chiropractors within your insurer’s network.
Care plans: Some insurers will ask that your primary physician develop a treatment plan that details your chiropractic needs, recovery options, and outcomes.
Restricted treatments: Chiropractors specialize in a variety of treatments. Your insurance company may cover all or just some of them.
Deductibles: You may be asked to pay for your treatments up to a certain amount before your coverage begins. We explain deductibles in more detail below.
If you are unhappy with the restrictions of your health insurance plan, contact your insurer to update your policy.
Understanding Chiropractic Care Deductibles
In California, many insurance plans require a deductible payment before you can benefit from your coverage. This means that you will need to pay for your care until your costs reach a certain limit. Any costs after that limit (and possibly up to another limit) will be covered by your insurance company.
For example, if your deductible is $25 and your care costs $150 per treatment, you will pay $25 and your insurance will cover $125 per treatment.
Remember that your deductible may apply per visit. If this is the case, you will need to pay the deductible amount every time you visit your chiropractor.
Different healthcare providers have different deductible payment requirements. Some may have a 0$ deductible, and others may have deductibles that restrict your ability to seek care.
If you would like to pay a lower deductible for your chiropractic care, your insurance company can help you change your plan. Generally, lower deductible costs result in higher monthly payments and vice versa.
What to Do if Your Health Insurance Doesn’t Cover Chiropractic Care?
If your insurance company doesn’t cover chiropractic care, there are still a number of ways to seek affordable treatment. Below are a few options you can explore.
Talk to Your Doctor
Your doctor is the most direct route to getting your chiropractic care covered by insurance. If your doctor deems that your care is medically necessary, most insurance companies in California will cover it.
Even if your insurer has refused a referral in the past, your doctor may be able to change the language in the referral or contact the insurance company directly to speak on your behalf.
Add a Rider
A rider is a separate insurance policy that amends your current coverage to include an additional type of care—in this case, chiropractic care.
There are many benefits to adding a rider to your insurance coverage. The biggest benefit is that you can maintain your current plan, saving you the hassle of changing healthcare providers or plans, while still getting coverage for a specific type of care that you need.
Another benefit is that your premiums increase only slightly when adding a rider, as riders only cover specific treatments. If you plan to visit the chiropractor often, a slight premium bump may save you a lot of cash in the long run.
Change or Alter Your Plan
Altering your insurance plan can be complicated, and changing to a different provider is a stressful and time-consuming task. And, not everyone is able to change their policy or provider.
However, it’s certainly worth looking into if it means you can save thousands of dollars per year.
Upgrading your current plan will extend the types of treatments covered. For example, paying an extra $100 per month may end up saving you $250 per month in chiropractic care.
If you’re interested in changing your plan, talk to your insurance provider or your employer (in the case of employer-provided coverage).
Pay Out of Pocket
Paying for chiropractic care out of pocket is sometimes the easiest and most affordable way to seek treatment. While chiropractic treatments can be costly, they are typically much more affordable than surgery and pharmaceutical alternatives. If you only need a few treatments, paying out of pocket is preferable to amending your insurance policy and paying higher premiums every month.
Patients who pay out of pocket can also benefit from convenient payment plans and special offers provided by their chiropractor.
At Family Chiropractic, we are dedicated to serving our local community in Redwood City. For those without coverage, we offer tailored payment plans and bespoke pricing so everyone can find the relief they deserve. If you are in need of treatment but are worried about your coverage, we are happy to customize a treatment plan that works for you. Contact us to learn more.
Why Isn’t Maintenance Care Covered by My Health Insurance?
If chiropractic care is considered “maintenance care” by your insurer, it may not be covered. Maintenance care describes a type of treatment that supports your well-being but does not directly cure a condition or alleviate symptoms.
Insurance companies don’t typically cover maintenance care because it does not address a specific injury or condition, and it can’t be measured or quantified. To insurers, this means that the coverage is not medically necessary, and therefore not payable.
Sometimes, chiropractic treatment will be covered up until a certain point when it is no longer deemed “corrective” (and therefore becomes maintenance care). Your insurer may stop covering your treatments at this time.
If your treatments are considered maintenance care by your insurer but you believe they are medically necessary, talk to your doctor.
Your Care is Covered at Family Chiropractic
Dealing with your insurance company can be stressful. At Family Chiropractic, we’re here to help. We partner with all of California’s major insurance providers to ensure you get the coverage you need for every visit.
For those without coverage, we provide tailored payment plans and special discounts. Redwood City has been our home for over 35 years, and we’re dedicated to serving the community by ensuring that everyone who needs treatment gets the care they deserve.
Stop by our office on Main Street or visit us online to schedule a consultation. We offer a broad range of chiropractic and massage treatments for muscle and joint pain, sports injury, chronic discomfort, and much more. Contact us today to learn more about affordable chiropractic care at Family Chiropractic.
