If you’re considering chiropractic care, insurance coverage might be one of your main concerns. Many patients want to know if their treatments will be covered by their insurance plans, or if they will be responsible for the entire bill.
First, it’s important to understand the difference between coverage and mandated coverage. Coverage simply means that your insurance plan will pay for a particular service. Mandated coverage means that all insurance plans are required by law to provide for that service.
The Affordable Care Act (ACA) established a set of essential health benefits (EHBs), which apply all ACA-compliant health insurance plans. In many cases these EHBs provide for a category of care, but the details are left up to the insurance carriers themselves.
The ACA does not specify that chiropractic care must be covered by health insurance plans, so it is not a guaranteed EHB. However, some insurance plans do offer some coverage for chiropractic care. That coverage usually comes with limitations; for example, routine preventive care is often not provided, but chiropractic care after an accident or injury might be. When in doubt, contact your plan’s administrator to discover what your policy does and does not cover.
In California, coverage for chiropractic care has become more common. And while many health insurance providers still do not offer coverage as a primary benefit, a chiropractic care rider is available through some insurance companies. A “rider” is essentially additional coverage that is added onto a health insurance plan, such as dental insurance, vision insurance, and so on. With a rider, you will usually pay a fixed fee for each chiropractic visit, and your main deductible might be waived.
Since each insurance plan varies in its coverage, the best course of action is to either call your insurance company, or call us. We can help you determine whether your insurance provider offers coverage for your treatment.