Does Medicare cover chiropractic?

If you’re struggling to understand Medicare, Connie can help. Ask Connie your question, and a local, licensed agent will help you navigate your Medicare journey. Complete this form to have your question answered. It could be featured on Dear Connie.

Dear Connie,

I have been going to a chiropractor on a regular basis for the past five years. I recently enrolled in Medicare, and I’m confused and worried that I won’t be able to go to my standard chiropractic visits. They have given me so much pain relief. I’m wondering, does Medicare cover chiropractic?

Needing an adjustment,
Thomas from Broward, Florida

Need Help Deciding The Right Medicare Coverage For You?

• Free, unbiased service
• Compare all major plans and carriers
• Local, licensed insurance agents with 25+ years of experience

Call Now Compare Plans

Dear Thomas,

When you first enroll in Original Medicare Part A and B, it’s understandable that you’d be concerned about continuing your normal care. Plus, the parts of Medicare can be confusing. We’re happy that you reached out with your question.

The answer is – it depends.

Original Medicare Part B will cover medically-necessary chiropractic services for manual manipulation of the spine to correct a subluxation. A subluxation is when the bones in the spine are separated or out of alignment. An incomplete or partial dislocation is nearly always visible in X-rays.

Subluxation symptoms could include:

• Pain at the point of injury
• Swelling
• Reduced mobility
• Headache
• Numbness or tingling
• An altered range of motion, and more.

To remedy a subluxation of the spine, a chiropractor will adjust your spine with their hands (manually) to help realign the vertebra and relieve your symptoms.

Agent tip:

“Original Medicare Part B does not cover chiropractic maintenance, but some Medicare Advantage plans provide this coverage.“

Chiropractic treatment is only covered by Medicare Part B when it is deemed medically necessary. And your primary care physician will determine this.

“Medically necessary” means the care needed to treat an illness, injury, condition, or disease. As long as the chiropractic visits are deemed medically necessary, Medicare may cover your visits. And your physician will provide the chiropractor orders once it’s determined that you have a spinal subluxation that requires chiropractic treatment.

Medicare Part B will only cover chiropractic services for a subluxation, either acute or chronic. Acute conditions usually occur suddenly and briefly, while chronic conditions develop slowly and worsen over time.

With Original Medicare, this treatment will still cost you. You first need to pay the Medicare Part B annual deductible, then 20% of Medicare-approved services once the Part B deductible is met. Medicare will pay the other 80% of the Medicare-approved cost.

If you have a Medigap plan, also known as a Medicare Supplement plan, that plan will cover all or part of the 20% Medicare Part B coinsurance cost.

Need Help Deciding The Right Medicare Coverage For You?

• Free, unbiased service
• Compare all major plans and carriers
• Local, licensed insurance agents with 25+ years of experience

Call Now Compare Plans

Original Medicare will not cover other services or tests that a chiropractor or other qualified provider might order. These services include X-rays, ultrasound treatments, traction therapy, and massage therapy.

If the care you’ve been receiving from a chiropractor is for maintenance after your spine has been realigned, that would not be covered by Original Medicare.

If your chiropractic care is for maintenance, you should look into coverage under a Medicare Advantage plan. Medicare Advantage plans may provide additional chiropractic coverage – routine and maintenance chiropractic care – not covered by Original Medicare.

Medicare Advantage plans in Florida start at a $0 monthly premium and often include dental, vision, hearing, and other benefits – like chiropractic.

Depending on your Medicare plan, you may need prior authorization and a referral to an in-network chiropractor before your plan will pay. An agent can help you find a plan that includes the chiropractor you currently see.

I hope that this information was helpful and clarified your question on whether Medicare covers chiropractic. Being new to Medicare can be confusing, and you do not have to handle it alone.

At Connie Health, we help you throughout your Medicare journey. If you have additional coverage questions, contact a local licensed Connie Health agent at (623) 223-8884 (TTY: 711) for help.

Sources

Chiropractic services.

Last updated: February 24, 2023

Frequently Asked Questions

How many chiropractic visits does Medicare allow?

There is no limit to the number of chiropractic visits covered by Medicare, but they must be medically necessary. Medicare will only cover medically necessary spinal manipulation to correct a subluxation.

Medicare will not cover regular or preventative chiropractic maintenance or treatments.

 

Does Medicare Part B cover chiropractic?

Medicare Part B covers chiropractic services for a subluxation, either acute or chronic. Acute conditions usually occur suddenly and briefly, while chronic conditions develop slowly and worsen over time.

With Original Medicare, this treatment will still cost you. You first need to pay the Medicare Part B annual deductible, then 20% of Medicare-approved services once the Part B deductible is met. Medicare will pay the other 80% of the Medicare-approved cost.

If you have a Medigap plan, also known as a Medicare Supplement plan, that plan will cover all or part of the 20% Medicare Part B coinsurance cost.

How much does Medicare pay for a chiropractic adjustment?

You first need to pay the Medicare Part B annual deductible, then 20% of Medicare-approved services once the Part B deductible is met. Medicare will pay the other 80% of the Medicare-approved cost.

If you have a Medigap plan, also known as a Medicare Supplement plan, that plan will cover all or part of the 20% Medicare Part B coinsurance cost.