Does Insurance Cover Chiropractic Care?

Health insurance companies often cover chiropractic care if it is necessary for the treatment of a medical condition or injury, but they typically don’t cover continuous care designed to maintain a healthy lifestyle. In addition, some chiropractors do not take health insurance, which means you may have to pay out of pocket even if your insurance does cover chiropractic care.

Keep reading to find out more about when chiropractors are covered by insurance and how much a chiropractor visit may cost without insurance coverage.

On This Page

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  How Does Insurance Cover Chiropractic Care?

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  Are There Insurance Restrictions for Chiropractic Treatment?

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  Why Doesn’t Health Insurance Pay for Maintenance Chiropractic Care?

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  What Happens if My Provider Doesn’t Cover Chiropractic Care?

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  Which Health Insurance Providers Cover Chiropractic Care?

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  How Can I Find Out if My Insurance Covers Chiropractic Treatments?

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  FAQs

How Does Insurance Cover Chiropractic Care?

Health insurance plans usually cover chiropractic care as long as it is part of an active treatment plan — meaning it is used to treat the symptoms of a specific injury or body pain.^[1] However, each insurance carrier may set its own stipulations that you must meet to qualify for chiropractic coverage. For example, Aetna only considers chiropractic procedures to be medically necessary if all of the following conditions are met:^[2]

• You have a neuromusculoskeletal disorder
• Your need for treatment is well documented
• The chiropractic care begins to improve your condition within two weeks (or within 30 days if the treatment is modified after two weeks)

Some chiropractors decline to accept insurance, so it’s important to communicate with your chiropractor up front — even if you know your insurer is willing to cover their services.^[3]

Are There Insurance Restrictions for Chiropractic Treatment?

Chiropractic is not considered an essential health benefit under the Affordable Care Act, which means it may be subject to coverage limits.^[4][5] For example, your insurance company may set a maximum amount of money it will pay toward chiropractic care during a year or throughout the entire life of your plan, and you may have to cover 100% of the costs for care out of pocket after reaching the limit.

Conversely, your insurer could set a limit on the number of covered visits rather than setting a dollar limit. Your insurance company may also require you to receive a referral from your primary care physician before it will cover chiropractor visits.^[1] Of course, if you have a health maintenance organization — or HMO — plan, you will need a referral to see a specialist anyway, and you will only be able to visit providers that contract with your plan’s network.

Keep in mind that most health insurance plans come with a deductible — a set amount you must spend out of pocket on health care, including covered chiropractic services, before the plan starts to provide coverage. Even after reaching your deductible, you may still have to cover a portion of the costs for your chiropractic care by paying copays or coinsurance out of pocket.

Why Doesn’t Health Insurance Pay for Maintenance Chiropractic Care?

In general, health insurance companies only cover chiropractic care prescribed for the treatment of an injury rather than care aimed at maintaining a healthy lifestyle. As a result, your plan may not cover maintenance care after your condition has been successfully cured, and it may also cease to cover treatments if they have no tangible impact on your symptoms.^[2]

What Happens if My Provider Doesn’t Cover Chiropractic Care?

If your health insurance doesn’t ordinarily cover a certain chiropractic treatment plan, you may be able to contact your insurance company to request an exception. Consider asking your primary care doctor to get in touch with your health insurance company as well so they can explain why they believe chiropractic services are medically necessary for you.

Alternatively, you could purchase a supplemental health insurance plan that enables you to save money on chiropractic. For example, supplemental health plans from Cigna allow you to secure discounted rates on health and wellness services, including chiropractic treatments.^[6] If all else fails, you will need to pay for your chiropractic care out of pocket — which generally costs around $60 to $200 per visit without insurance.^[7]

Which Health Insurance Providers Cover Chiropractic Care?

Here are some examples of major health insurance companies offering plans that include coverage for chiropractic care:

• Aetna
• Anthem
• Blue Cross Blue Shield
• Cigna
• Kaiser Permanente
• Molina
• Oscar
• UnitedHealthcare
• Wellcare

You may also be able to receive chiropractic coverage through a publicly funded health care program — if you are eligible. For example, Medicare Part B covers manual manipulation of the spine to correct a vertebral subluxation, but it doesn’t cover chiropractic X-rays, acupuncture, massage therapy or any other services or tests ordered by a chiropractor.^[8]

Meanwhile, roughly half of the country’s state-run Medicaid programs cover chiropractic benefits as of 2018.^[9]

How Can I Find Out if My Insurance Covers Chiropractic Treatments?

The best way to definitively determine whether your health insurance plan covers certain chiropractic services is to call your insurance agent or another representative from your insurance provider and ask. You may also be able to view your plan’s covered benefits by logging in to an online portal or checking your insurance policy documents.

If your current provider doesn’t cover chiropractic, you may want to shop around through an independent insurance marketplace, like SmartFinancial. Simply answer a few questions online, and we’ll get to work on finding plans that match your coverage needs and budget. Click here to enter your ZIP code and begin comparing health insurance quotes for free!