Does Medicaid Cover Chiropractic Care?

Does Medicaid Cover Chiropractic Care?

Chiropractic care may be prescribed to treat a variety of ailments but check with your local Medicaid office to make sure it’s covered, first.

As with most services, whether Medicaid covers chiropractic care depends on the state you live in. Chiropractic care is not one of the services considered mandatory by the federal government, so it is left up to each state to decide whether to cover it.

When does Medicaid cover chiropractic care?

Simply put, Medicaid covers chiropractic care if your state has decided to include it as part of its Medicaid services.

You can check what is covered by your state's Medicaid program here. In addition to whether your state covers chiropractic care, you may see guidelines as to the types of chiropractic services covered, which would also vary from state to state.

Some possible guidelines include a maximum number of visits per month or year, maximum amount Medicaid will spend on care, and limits on X-ray services. It is also possible that your Medicaid program will only cover chiropractic care if it is deemed medically necessary. Again, be sure to check with your state at the link above to find out if chiropractic services are covered, as well as the other services your state program includes.

Does Medicare cover chiropractic care?

Some chiropractic care is covered by Medicare Part B, with beneficiaries paying 20% of the approved cost once the Part B deductible is met. Medicare covers spine manipulation to correct subluxation, which is an issue with the spinal joints. However, Medicare does not cover other services ordered by a chiropractor, including acupuncture (unless it is for chronic lower back pain), massage therapy, or X-rays.

What is subluxation?

As stated above, subluxation is an issue with the spinal joints. But, more specifically, it is a separation of the articular surfaces of the joint. This means the joints don't move properly, but there is still contact between them.

Subluxation can cause pain and limited mobility, as well as:

  • Atrophy: If the pain or lack of mobility is severe enough, it may cause muscle atrophy due to decreased or ceased movement of the muscle tissue surrounding the area.
  • Edema: If the subluxation damages or puts pressure on capillaries (tiny blood vessels) the excess fluid can leak, building up in tissue and causing a swelling known as edema.
  • Fibrosis: This occurs when normal tissue is replaced with scar tissue, which can happen depending on the severity and location of the subluxation. Fibrosis is common in those with recurring back pain.
  • Rigidity: Adhesions and rigidity can form not only in the joint capsules, but also in muscles, ligaments, and tendons due to decreased blood flow or lack of movement.

What causes subluxation?

There are multiple factors that can lead to subluxation, such as:

  • Stress: As we get tense (both physically and mentally) our bodies get rigid, with many people holding tension in their neck and upper back. Tight muscles caused by stress can easily lead to subluxation.
  • Toxins: While this does mean toxins in a chemical sense (cleaning products, pesticides, etc.), it also refers to the toxins your body may absorb from air pollutants or a poor diet.
  • Trauma: Car accidents, falls, and improper lifting can all lead to spinal issues, and are typically what people think of when they hear the term back trauma. But micro-traumas, like wearing improper footwear, sustained postures, or even wearing a backpack or purse on one side only, can cause subluxation.

Spinal subluxation can occur as early in life as childbirth, as a newborn's spine goes through a large amount of stress during the process of childbirth. Spinal trauma at any age often leads to neurological issues and other health problems.

The most common warning signs of subluxation are back pain, headaches, neck pain, decreased movement, or an outright inability to move. If you are experiencing any of these symptoms, contact your physician to see if chiropractic care can help.

Diagnosis and treatment

Typically, a chiropractor is the one who will diagnose you with a subluxation of the spine, as they have the most experience in dealing with the disorder. Treatment generally involves spinal manipulation, with a chiropractor building a plan and schedule to help get your spine back into shape. While manipulation is the most common treatment method, they may also prescribe acupuncture or medication to help with the process.

Minor subluxation issues might be treated with a less hands-on approach, such as through specific exercise regimens, over-the-counter pain medications, stretches, or rest. The treatment plan the chiropractor builds is based on the severity of your subluxation and any other mitigating factors that need to be considered.

Can Medicare help?

If you have both Medicare and Medicaid, you are what is known as dual eligible and may qualify for additional benefits. Call us toll-free at 888-992-0738 to speak with a licensed ClearMatch Medicare agent. They’ll answer your questions and explain your coverage options.

Additional resources

After retiring from a career as an executive travel counselor in 2006, Donna Frederick embarked on a second career as a licensed insurance agent. During that first year, many clients told Donna how overwhelmed they felt by Medicare, but that her assistance helped them finally understand the Medicare program. That experience inspired Donna to focus her efforts on educating her clients to ensure they fully understand their Medicare options. Today, Donna takes pride in providing outstanding customer service and going the extra mile to make sure each client knows all of their options and has a sound understanding of their Medicare plan, from costs to coverage and all points in between.


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