Original Medicare covers “medically necessary” chiropractic services to correct a subluxation; that is, a spinal alignment correction. While Medicare Part A doesn’t cover chiropractic visits or treatments, other parts of Medicare may provide partial coverage for specific services.
FYI: Medicare Advantage can provide additional coverage beyond Medicare Parts A and B. To learn more, read our guide to this year’s Medicare Advantage providers.
What Chiropractic Care Does Medicare Cover?
According to Medicare.gov, Medicare covers “manual manipulation of the spine to correct a subluxation.” Since this procedure is provided by a chiropractor and considered medically necessary, Medicare can pick up 80 percent of the cost.
This means that you’d have to pay 20 percent of the Medicare-approved amount after the Part B deductible. However, Medicare doesn’t cover basic tests related to chiropractic care such as X-rays, massage therapy, and acupuncture — with the exception of treating lower back pain.
What Parts of Medicare Cover Chiropractic Care?
Different parts of Medicare can be used to cover some of the cost of specific chiropractic treatment. However, you may need to pay additional out-of-pocket costs or deductibles depending on your plan. I’ll review the parts of Medicare that may provide some financial relief for chiropractic care.
Medicare Part A
If you have Medicare Part A, it won’t cover visits to the chiropractor or treatments like correcting a subluxation. This means you’ll have to pay 100 percent of the cost of chiropractic care.
Medicare Part B
Medicare Part B covers chiropractic care when it’s considered medically necessary by a chiropractor or physician, such as the manual manipulation of the spine for a subluxation. If you have Medicare Part B, the yearly deductible applies and you’d be responsible for paying 20 percent of the Medicare-approved amount. Unfortunately, X-rays, massage therapy, and other services are not covered by Medicare.
Medicare Advantage
If you have Medicare Advantage (Medicare Part C), you’ll need to reach out to your carrier directly to find out if your plan will cover additional chiropractic services or procedures. These plans vary from carrier to carrier. You can also look through your summary of benefits that was mailed to you upon enrolling.
Medigap/Medicare Supplemental Insurance
Medigap, or supplemental insurance, will cover “gaps” in coverage that Original Medicare leaves up to the beneficiary to pay out of pocket. If Original Medicare covers the service, your Medigap plan will cover the coinsurance. Depending on the letter plan you have, the deductible under Part B may also be covered.
Pro Tip: Are you healthy but still looking for comprehensive coverage? Read my article on how to choose the best Medigap policy.
What Does Chiropractic Care Cost With Medicare?
| Average cost of shoulder dislocation treatment | Medicare coverage | Out-of-pocket cost | Deductible | Total cost |
|---|---|---|---|---|
| $571 | $456.80 | $114.40 | $226 | $340.40 |
Out-of-pocket chiropractic visits can range anywhere between $60 to $200 for each session. For example, a full-body adjustment or alignment therapy session can average around $65, though these costs can vary.
Original Medicare, however, can cover only one medically necessary service: spinal manipulation to correct a subluxation. This treatment is covered by Medicare Part B and is usually done by a professional chiropractor. In this case, Medicare pays 80 percent of the Medicare-approved treatment after the patient pays their deductible.
This means that you’ll be responsible for 20 percent of the remaining costs of the treatment, including additional out-of-pocket costs that are not covered by Medicare: x-rays, acupuncture, massage therapy, and other tests that are ordered by a chiropractor.
Paying for a Chiropractor With Medicare
Legislation has been introduced in the U.S. House of Representatives to increase Medicare coverage of chiropractic services. The Chiropractic Medicare Coverage Modernization Act (H.R. 2654) would grant Medicare recipients access to various chiropractic services. Under the legislation, a patient would have rights to all Medicare-covered benefits.
To find a chiropractor that accepts Medicare, you can search Medicare.gov and click on “Find & compare nursing homes, hospitals & other providers near you.” From there, you can search by provider type and type in chiropractic under the “name and keyword” search. When you search by location, you’ll receive information about whether the provider charges the Medicare-approved amount and accepts Medicare.
Did You Know: At least a quarter of people enrolled in Medicare have supplemental policy coverage. Read my guide to help you find the Best Medigap Plan D.
The Senior List Medicare Guides
Medicare coverage can be tricky, but luckily we’ve done the research to learn exactly what is covered and to what extent. To learn more, check out our helpful guides:
- Does Medicare Cover Eye Exams?
- Does Medicare Cover Hearing Aids?
- Does Medicare Cover Hospice?
- Does Medicare Cover Oxygen Concentrators?
- Does Medicare Cover Walk-In Tubs?
Medicare and Chiropractic Frequently Asked Questions
- Does Medicare pay for a chiropractor visit?
Medicare will only pay for chiropractic visits for manual manipulation of the spine that are deemed “medically necessary” by a provider or chiropractor.
- Does Medicare require a referral to see a chiropractor?
No, you don’t need a referral to see a chiropractor under Original Medicare. However, if you’re enrolled in a Medicare Advantage plan, you will most likely need prior authorization.
- When did Medicare start covering chiropractic?
In 1972, Medicare started covering one medically necessary service known as manual manipulation of the spine.
- Does Medicare cover chiropractic for sciatica?
In certain circ*mstances, individuals who suffer from sciatica or lower back-related pain can receive some Medicare coverage if they require lumbar epidural steroid injections to alleviate pain.
- Does Medicare limit the number of chiropractic visits?
Currently, there is no limit as to the number of medically necessary chiropractor visits you can have.
