Understanding How Medicare Works For You


What does Medicare pay for?

Medicare will pay for 80% of medically necessary chiropractic adjustments.


What will Medicare NOT pay for?

Medicare will NOT pay for exams, therapies or extremity adjustments (elbows, knee, wrist, ankle, etc.) They also will NOT pay for ongoing MAINTENANCE care (care to keep your pain from coming back or to manage a chronic condition).


What Does Medicare Expect From My Treatment Plan?

Medicare expects a treatment plan of one month, followed by a re-examination. They expect 30% improvement in that thirty days or we are to refer you to another provider. If you make at least 30% improvement in that thirty days, we will continue treatment as stated above until progress can no longer be made. At that point we will either refer you to another provider or release you from active treatment.


What Does Medicare Require?

Medicare requires an initial examination in order to pay for your adjustments and a re-examination at specified times. They also require an examination for any new injuries or re-injury to a problem we have previously treated. Medicare also requires you to sign an ABN (Advance Beneficiary Notice) form stating you understand what they will and will not pay for. Medicare requires the examinations but will not pay for them. If you refuse an examination, we can not treat you.


What If I Want To Continue Care (Maintenance)?

Most people want to prevent future problems by receiving chiropractic care on a regular basis. Research shows that treatments every two weeks for chronic conditions give the best chance at avoiding a relapse. It should be understood, Medicare will not pay for maintenance care.