Does Health Insurance Cover the Cost of Chiropractic Care?

 In Technique

Because chiropractic care is often labeled as “alternative medicine,” it can be difficult to know whether or not it will be covered by an insurance policy. It is important for patients to understand that this sort of coverage varies from provider to provider and from plan to plan. Here are the factors that affect whether or not a patient’s health insurance might cover the cost of his or her chiropractic care. For more detailed information, however, it is best for patients to contact their individual health care provider. The health care provider will be able to answer in depth what treatments are covered and which treatments are not covered under the plan.

How Chiropractic Care Is Labeled by the Insurance Company

If chiropractic care is classified as alternative or “complementary” medicine by an insurance provider, it might not be covered by a plan that covers just “conventional” medicine. In this situation, the patient should contact the health care provider for detailed information.

In some cases, health insurance covers a set number of chiropractic visits every year. Patients should research the details of their coverage, and attend chiropractic appointments if they are covered by insurance.

Whether or Not Chiropractic Care Is Viewed as Experimental

Insurance companies usually only like to pay for treatments that they are sure will be effective. While the patient might know that a treatment that the insurance company won’t cover is actually effective, most insurance companies prefer conventional medicine to experimental, alternative, or complementary treatments. If they deem chiropractic care to be experimental, they might decide not to cover it and any costs of treatment will be in the hands of the patient. Again, if the patient has a question about whether or not a treatment is covered, it is best to contact the health care provider directly.

Whether or Not the Patient Can Prove that the Treatment Is Medically Necessary

Anyone who has ever dealt with an insurance company knows that a large part of getting reimbursed for treatments is proving that that treatment is medically necessary. This might be as easy as providing doctor’s notes to the insurance company, to prove that the chiropractor believed the treatment would help relieve a real ailment, as well as providing test results, both before and after treatment, in order to determine whether or not the treatment was necessary and was effective.

Whether or Not the Treatment Was Recommended by a Primary Care Physician

In some instances, all an insurance company needs in order to determine whether or not they will cover a treatment is a note from the patient’s primary care physician. Just as with any referral, proper documentation from the referrer (the patient’s primary care physician) can be more than enough to prove to an insurance company that the treatment was necessary. Often, having treatments that are deemed experimental or non-conventional approved by a conventional doctor is all an insurance company needs in order to cover that type of care.

For more information about chiropractic care, patients should contact the experts at Horst Chiropractic. Any of the staff members at the office would be happy to help schedule an appointment, or answer any questions.

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