Medicare, Medicare Replacements, Medicare Advantage and Medicaid

Our office strives to keep chiropractic care affordable and transparent to our patients with these types of insurances.

Medicare:

Whether you have traditional (red/white/blue card) or a replacement (Humana, Essence, AARP, etc.), none of these plans will pay for anything but the Chiropractic Adjustment/Manipulation. That means examinations, x-rays, therapies or any other procedures performed by a Chiropractor will not be covered and is considered the patient’s responsibility. The initial visit at this office will be $50, which will include, examination, therapies and the adjustment.

Traditional Medicare has a yearly deductible (varies each year) that must be met by the patient before Medicare will pick up their part. Whether you hit your deductible or not, any therapies done beyond the initial visit will be a $10 charge.

Medicare Replacements, if you call the insurance they will state (ex. Humana/Essence), “you only owe $20 a visit”. That is true if you were just getting the adjustment, on a day other than the initial visit. If you ask if they pay for the initial examination or therapies they will tell you no.

Medicare and Secondary Insurances*:

Secondary insurances work the same as Medicare. If Medicare pays for it, then they will pay for it. If you do the adjustment by itself, Medicare will process and then send it to the secondary insurance to pick the rest of the copay up. Remember copays ONLY cover the adjustment.

Medicaid*:

Medicaid can only be used in the state where it was issued (can’t use Illinois Medicaid in Missouri). Medicaid will pay for the initial examination and adjustments. Patients will not owe anything on their first visit, after the initial visit it will cost $10 to have therapies. Medicaid replacements will usually pay for therapies, so patients with those plans will not owe anything each visit.

Currently in 2023 the visit limit is 20 rolling visits a year. Rolling visits means if you start on March 1st, your 20 visits will restart the next year on March 1st.

*All insurances are different and benefits change yearly, if at anytime we are paid for something that we believed wouldn’t be paid by insurance, we will refund the patient as soon as possible.