Chiropractic care is typically included in many medical insurance plans, including employer-group health and private insurance purchased through state marketplace exchanges or directly from insurance providers. It is essential to understand how the cost of coverage, limits on visits, and other factors affect your decision. Chiropractors also need a general liability policy to protect them from business-related risks such as slip-and-fall accidents, property damage, and worker’s compensation costs.
Cost
Many health insurance plans provide coverage for chiropractic care. For example, BCBS covers chiropractic. In addition, a health insurance plan’s annual limit on how frequently you can visit your chiropractor can also affect the decision-making process. This annual limit can be restrictive, especially if you are in active care after an injury that requires frequent treatment. If you struggle to afford your health insurance plan’s deductible, consider talking with your chiropractor about your financial situation. They may be able to help you by offering payment plans or third-party financing. You could also look into supplemental insurance, which covers expenses that a standard health plan does not.
Coverage
While most healthcare plans offer some chiropractic coverage, restrictions often dictate when and how it is covered. These may include whether or not a patient must meet their policy’s deductible before coverage or if the provider must be an in-network member. Some plans will also restrict which chiropractors patients can see based on the plan type. For instance, HMOs usually only cover visits to a list of approved providers, while PPOs sometimes allow some out-of-network coverage. Generally, most insurance plans will cover chiropractic costs on an active care basis (i.e., visits during the initial treatment phase after an injury). Still, they may not cover them on a maintenance or long-term care basis. This is why it is essential to thoroughly review your health insurance policy before selecting a chiropractor. In addition, some plans will cap how many visits can be made in a month or year or require that patients first receive a referral from their primary care physician before they can schedule an appointment.
Network
Most healthcare plans generally include chiropractic care, though the exact details will vary by plan. For example, some plans may require a referral from your primary care doctor before seeing a chiropractor. Others may only cover the visits you make after you’ve met your deductible. Still others may have a limit on how many visits per year they’ll pay for, or they might only cover preventive chiropractic services (which aren’t usually considered medically necessary). Generally speaking, employer-sponsored health insurance plans will provide the most outstanding coverage for chiropractic care, as they typically don’t have deductibles.
Benefits
Most health plans will limit how many times you can visit a chiropractor per year. This is typically done to protect the insurance company from unnecessary spending. These limits are generally based on whether your visits are considered a medical necessity, defined by the health insurance company based on the cause of your chiropractic treatment. The types of insurance plans you have will also affect your costs. For example, HMOs typically require you to choose a chiropractor from their approved list, while PPOs may sometimes provide coverage for chiropractors outside of their network. If you have a high-deductible health insurance plan, consider enrolling in a gap health insurance plan that will cover chiropractic visits up to a certain annual or monthly maximum. These are offered through state marketplace exchanges or directly from private insurance providers. Alternatively, you could also use an FSA or HSA to pay for chiropractic visits, as these funds can be used for qualifying healthcare expenses.
