Do Insurance Plans Cover Chiropractic in Oregon?

• Health Insurance – Mostly Yes
• Auto Insurance – Yes
• Workers Comp Insurance – Yes

Patients often call in asking if we accept insurance. The short answer is yes. The long answer can be a little more complex. Even though the Social Security Act Amendments made in 1972 updated the Medicare definition of the term “physician” to include chiropractors, many people wonder if chiropractic care is covered by insurance. This confusion is typically rooted in a misunderstanding of what chiropractic care usually entails. Chiropractic services are both very specific and very broad and can vary from practitioner to practitioner. A person may hear an anecdote of a person who was not able to obtain coverage for a specific service from an individual chiropractor and mistakenly believe that a lack of coverage applies to all chiropractic services. Most insurance does cover some chiropractic services, but not all insurance companies cover all services. Let’s dive deeper.

What Are Chiropractic Services?

If you think of the field of chiropractic care as a tree, the basic tenet, or the trunk of the tree, is spinal manipulation to bring about the proper alignment of the body’s musculoskeletal structure. From there, there are several “branches” that may be included in an individual practice such as dietary, exercise, and weight management counseling as well as hot and cold muscle treatments, soft tissue therapy, and physical modalities. Some of the latter services are considered to be “holistic” and outside of the realm of traditional medicine and therefore not covered under some types of insurance plans. Individual chiropractors may include different branches and different combinations of branches, but they all would be expected to offer spinal manipulation which is usually covered by insurance. Some chiropractors only offer spinal manipulation.

The Benefits Of Chiropractic Care

Chiropractic care is a non-surgical, drug-free, approach to providing relief of sciatica, pinched nerves, and back or neck pain, some of which may be caused by auto accidents and sports injuries. Chiropractic care can also help relieve headaches, reduce stress, and provide whole-body healing. During chiropractic treatment, a practitioner will apply pressure to the lower and upper back in a precise manner which manipulates the joints of the spine to realign them and put them back into place. The reason spinal manipulation is effective in relieving pain is because the majority of your nerves pass through your spine. When your spine is out of alignment, the nerves can become constricted or even pinched which can cause pain, headaches, and other ailments.

Types of Insurance That Cover Chiropractic Services

The answer to the question about whether chiropractic care is covered by insurance is complicated by the fact that different types of insurance cover chiropractic care. Because spinal manipulation and other chiropractic methods are often used to treat injuries, there are different scenarios where different types of insurance might apply. The three main types of insurance that cover chiropractic care are:

• Workers’ Compensation
• Auto Insurance
• Health Insurance

The type of insurance that will cover your chiropractic treatment, and what that insurance will cover, depends on what type of claim that was filed. For example, if you were in an auto accident and the other driver was at fault, their insurance would cover your chiropractic treatment even if you had individual health insurance that would also cover it.

Workers’ Compensation Coverage

If you are injured at your place of employment, regardless of fault, workers’ compensation will cover any costs related to the treatment of your injuries. Workers’ compensation insurance is state-regulated, so the coverage limits can vary from state to state. All fifty states include chiropractic care under their state workers’ compensation laws. Most states cover a limited number of chiropractic visits, although this can be extended when necessary. In Oregon, for example, workers’ compensation will cover 18 visits or 60 days of care. Most services offered by a chiropractor will be covered by a workers’ compensation claim, but you can ask your chiropractor if any services offered will not be covered to avoid any out of pocket costs.

Auto Insurance Coverage

Liability auto insurance coverage provided by the at-fault driver covers a limited amount (determined by their coverage limits) of “medically necessary” treatment for injuries sustained during an accident. While most auto insurance will cover chiropractic care, some claims may be disputed for not being medically necessary. This often has to do with the extent of the injuries rather than the legitimacy of the treatment. Some auto insurance companies go to great lengths to avoid paying medical bills whether they are incurred at a doctor’s office, chiropractor’s office, or a hospital. If you have issues with getting treatment for injuries covered by the other driver’s insurance, you should seek the advice of an attorney. We accept several auto insurance providers including Progressive, State Farm, Farmers, Allstate, and any other company that provides coverage in Oregon.

Health Insurance Coverage

The vast majority of traditional insurance policies cover chiropractic treatment as a benefit. Some reports indicate that as many as 87% of American workers who have health insurance through their employers have chiropractic service coverage included in their health insurance plans. The U.S. Congress has authorized Medicaid and Medicare to cover basic chiropractic services, like spinal manipulation. The Federal Employee Workers’ Compensation Program and the Federal Employee Health Benefits Program include chiropractic care for federal workers. It is also available to members of the military at over 60 military bases through VA medical coverage. The Railroad Retirement Act includes chiropractic services. It is important to note that chiropractic services are recognized by the Internal Revenue Service as a valid medical deduction. If you have questions about what your health insurance plan covers, contact your health insurance provider to discuss your plan benefits.

Chiropractic Care at Starkwood Chiropractic

Here at Starkwood Chiropractic, our focus is on using safe, gentle, and effective methods for the experienced removal of pain. We work with patients who have sustained work-related, auto, and sports injuries as well as providing relief for people with neck pain, back pain, sciatica, and chronic headaches. Our pain relieving services include spinal adjustments, physical modalities, soft tissue therapy, dietary and nutrition counseling, as well as stretching and exercise programs. We use Diversified, Thompson, Arthrostim, Activator, Physical Therapy, and Physiotherapy in a whole-body, holistic approach that effectively alleviates pain rather than masking it with pain relievers and addictive medications. We also use Therapeutic Ultrasound and Electric Muscle Stimulation, Zenith HyLo Elevation Tables, and Heritage10 Intersegmental Traction Tables. We work with your physician to ensure the best treatment plan for you. We accept insurance from major health insurance companies such as Blue Cross Blue Shield, Aetna, Moda, Providence, Cigna, Health Net, and many others.

Contact Starkwood Chiropractic Today

If you have questions about what your insurance will cover, especially if you have experienced injuries from an auto or work-related accident, you can contact us to discuss what services you would expect to be covered. Because we have been providing chiropractic care in the Portland, Oregon, area since 1983, we have a lot of experience working with insurance companies. We can explain to you what your claim will cover and what out of pocket costs, like co-pays, you might experience depending if you are covered by auto insurance, workers’ compensation insurance, Medicare, Medicaid, VA, or private health insurance. We would also advise you to contact your health insurance provider to ask what chiropractic services are covered with your plan. If you are in pain, don’t delay. Call us right away and see how Starkwood Chiropractic can help you start taking steps toward a pain-free life. Call us today.