Medicare and Chiropractic Services: What Is Covered?

Medicare covers a chiropractor specifically for manual manipulation of the spine to correct a subluxation. Original Medicare (Parts A & B) does not cover other services or tests ordered by a chiropractor, such as X-rays, massage therapy or acupuncture.

Some Medicare Advantage plans (Part C) may provide additional chiropractic coverage. Check with your Medicare Advantage plan directly to see what chiropractic services are covered.

What is Subluxation of the Spine?

Subluxation of the spine is when the vertebra – the bones in the spine – are separated or out of position. Symptoms may include pain, headache or stiffness, though these may have other causes as well. Chiropractic treatment involves adjusting the spine manually (with the hands) to help realign the vertebra and relieve the symptoms.

Subluxations (spinal and nervous system dysfunction) can be caused by stressors (or forces) that your body cannot adapt to including:

• Physical (both macro and micro-traumas) such as the birth process, learning to walk, car accidents, accidents at work or home, poor posture (school, work, home), sports injuries, lifting children, prolonged sitting or standing, repetitive activities etc.
• Chemical factors including neurotoxins, excessive alcohol, tobacco, sugar, artificial sweeteners, food colouring, caffeine, MSG, biochemical constituents of foods (eg. grain-fed red meat, hydrogenated fats), environmental toxins (eg. mercury and other heavy metals), lack of proper nutrients (such as essential fatty acids, vitamins, minerals, protein), endocrine changes (for example increased relaxin and estrogen levels in pregnancy).
• Emotional tensions like chronic stress, family conflict, grief, anxiety, depression etc. These tensions subconsciously influence our posture and neurological tone.

One or a combination of these factors can result in alterations to joint function and neurological integration. Physical causes are the most obvious, but not necessarily the most common.

How Many Chiropractic Visits Will Medicare Cover?

Medicare covers chiropractic visits for medically necessary manual manipulation of the spine. “Medically necessary” means that the treatment is needed to diagnose or treat an illness, injury, condition or disease – or the related symptoms – and that it meets accepted standards of medicine.

In effect, Medicare may cover chiropractic visits for manipulation of the spine as long as the treatment meets the criteria to be deemed medically necessary.

How Much Does a Chiropractic Visit Cost with Medicare?

You will pay a 20 percent coinsurance for a chiropractic visit. Medicare Part B pays the other 80 percent of the Medicare-approved amount. The Part B deductible applies.

Your costs may be different with a Medicare Advantage plan so be sure to talk with your plan provider directly.