Does Health Insurance Cover Chiropractic Care?

Health insurance can help pay for chiropractic treatment, but coverage varies based on your plan. Some policies fully cover visits, while others require copays or deductibles. Knowing how your plan works prevents surprises when it’s time to pay.

Types of Health Insurance Plans

Different insurance plans offer varying levels of chiropractic coverage. Below is a breakdown of the most common types:

Indemnity Insurance (Traditional Fee-for-Service Plans)

(Placeholder): In today’s healthcare landscape, indemnity insurance plans are becoming few and far between. Some employers still offer this type of insurance as a choice and certain patients prefer this type of plan. The key factors for this type of insurance include:

• Choose any chiropractor or medical provider.
• Pay a deductible before benefits apply.
• After meeting the annual deductible, insurance covers a percentage of the cost based on their allowed fee.
• Any remaining balance is your responsibility called co-insurance or a copay. 

Preferred Provider Organizations (PPOs)

• PPOs offer a list of preferred chiropractors within the network.
• Seeing an in-network provider results in lower out-of-pocket costs.
• Working with out-of-network providers may lead to higher out-of-pocket expenses and reduced coverage.

Health Maintenance Organizations (HMOs)

• HMOs reimburse only when you visit in-network providers.
• Plans may require a referral from your primary doctor before seeing a chiropractor.
• Coverage outside the network may be limited or unavailable.

Self-Insured Health Plans

• Large employers or unions fund these plans instead of using traditional insurers.
• A Third-Party Administrator (TPA) manages claims and payments.
• Coverage varies, so checking with your employer’s benefits department is essential.

Exclusive Provider Organizations (EPOs)

• Only covers visits with contracted providers.
• No primary care doctor or referral is necessary.
• Out-of-network visits receive no coverage.

High Deductible Health Plans (HDHPs) with HSAs

• These plans have lower monthly premiums but higher deductibles and out-of-pocket costs.
• Preventive services may be covered before the deductible is met.
• These plans may include a Health Savings Account (HSA) to pay medical costs tax-free.

COBRA Coverage

• Allows you to continue your employer’s insurance after job loss or reduced hours.
• Coverage extends up to 18 months (or longer in special cases).
• You must pay the full premium, as employer contributions end.

Supplemental Health Insurance

• Covers additional out-of-pocket costs beyond primary insurance and Medicare.
• Can help with hospital stays, critical illnesses, or lost wages.
• Not a substitute for comprehensive health insurance.

How to Check If Your Plan Covers Chiropractic Care

Before scheduling an appointment, consider these steps:

1. Call your insurance provider to confirm chiropractic benefits.
2. Ask about copays, deductibles, and any visit limits.
3. Verify whether your chiropractor is in-network or out-of-network.
4. Find out if pre-authorization or a referral is required.

Understanding your insurance plan ensures fewer surprises and smoother billing. If you’re unsure, your chiropractor’s office can often help verify your benefits.