Yes, Medicare Advantage plans do cover chiropractic care. At minimum, they must provide the same coverage as Original Medicare for spinal adjustments. However, many Medicare Advantage plans offer extra benefits like routine chiropractic visits, X-rays, and other services that Original Medicare doesn’t cover.

This guide will help you understand exactly what chiropractic services are covered, how much you’ll pay, and what extra benefits you might get with a Medicare Advantage plan.

What Chiropractic Services Do Medicare Advantage Plans Cover?

Basic Coverage Requirements

Medicare Advantage plans must cover at least the same chiropractic services as Original Medicare, but copayments and deductibles may vary. This means all Medicare Advantage plans cover:

• Spinal manipulation (adjustments) for medically necessary treatment
• Treatment for subluxations (when spine bones are out of place)
• Manual spine manipulation using hands or devices

The treatment must be deemed “medically necessary” to correct a spinal problem that’s causing pain, restricted movement, or other symptoms.

Extra Benefits Many Plans Offer

Some Medicare Advantage plans provide a broader range of chiropractic services. This could include extremity adjustments, maintenance care, X-rays, and more. Common additional benefits include:

• Routine chiropractic visits for maintenance care
• X-rays and diagnostic testing
• Chiropractic examinations and re-examinations
• Adjustments to arms, legs, and other body parts
• Physical therapy and massage therapy
• Acupuncture services

How Much Do Chiropractic Visits Cost With Medicare Advantage?

Typical Copayment Amounts

Medicare Advantage plans cover chiropractic care, and your costs will typically be between $5 and $20 per adjustment. This is often much simpler than Original Medicare’s system.

Common cost structures include:

• $0 copay for routine visits (some plans)
• $15-30 copay per visit
• Set annual limits (like 12 visits per year)

Comparing Costs to Original Medicare

With Original Medicare, you pay:

• The 2025 Medicare deductible is $257
• 20% of the Medicare-approved amount (around $5-8 per visit after deductible)
• Full cost of any non-covered services

Medicare Advantage plans often provide more predictable costs with set copays instead of percentages.

What Original Medicare Covers vs. Medicare Advantage

Original Medicare Coverage (Part B)

Medicare Part B covers manual manipulation of the spine by a chiropractor to correct a vertebral subluxation. However, Medicare doesn’t cover other services or tests a chiropractor orders, including X-rays, massage therapy, and acupuncture.

What’s covered:

• Spinal adjustments only
• No limit on number of visits
• Must be medically necessary

What’s NOT covered:

• Initial examinations
• X-rays ordered by chiropractor
• Massage therapy
• Maintenance care
• Adjustments to other body parts

Medicare Advantage Enhanced Coverage

Some Medicare Advantage plans cover routine chiropractic visits as an additional benefit. This means you can get:

• Preventive care without needing a medical diagnosis
• Wellness visits for maintaining good health
• Comprehensive exams and assessments
• Additional services beyond spinal adjustments

How to Find Out What Your Plan Covers

Check Your Plan Documents

Every Medicare Advantage plan is different. To find plans in your area that cover additional chiropractic services, use the Medicare Plan Finder for plans in your zip code.

Steps to check coverage:

1. Look at your Summary of Benefits document
2. Call the customer service number on your insurance card
3. Visit your plan’s website
4. Use the Medicare Plan Finder tool online

Key Questions to Ask

When contacting your plan, ask about:

• Copay amounts for chiropractic visits
• Annual visit limits
• Whether you need referrals
• Coverage for X-rays and other services
• In-network provider requirements

Network Requirements and Provider Selection

In-Network vs. Out-of-Network

Medicare Advantage may require you to use an in-network provider. This is different from Original Medicare, where you can see any provider who accepts Medicare.

Important considerations:

• Always verify your chiropractor is in-network
• Out-of-network visits may cost significantly more
• Some plans have no out-of-network benefits
• Prior authorization may be required

Finding In-Network Chiropractors

Most Medicare Advantage plans have online provider directories. You can also:

• Call your plan’s customer service
• Ask your chiropractor’s office about your specific plan
• Use your plan’s mobile app if available

Special Considerations for Medicare Advantage

Prior Authorization Requirements

Some Medicare Advantage plans require prior authorization for chiropractic services. This means getting approval before treatment starts.

What you need to know:

• Traditional Medicare-covered services may need authorization
• Routine maintenance care usually doesn’t require authorization
• Your chiropractor’s office typically handles the paperwork

Billing and Claims Differences

Medicare Advantage plans may have different coverage rules, copayments, and referral requirements compared to Original Medicare. Your chiropractor may need to:

• File claims differently
• Use different billing codes
• Follow plan-specific requirements

Benefits of Medicare Advantage for Chiropractic Care

More Comprehensive Coverage

Many Medicare Advantage plans offer benefits that Original Medicare doesn’t cover:

• Routine maintenance visits for ongoing health
• Preventive care to avoid future problems
• Integrated care with other health services
• Wellness programs that include chiropractic care

Cost Predictability

Instead of deductibles and percentages, Medicare Advantage plans often use:

• Fixed copays per visit
• Clear annual limits
• Bundled service pricing

Coordinated Care

Medicare Advantage (Part C) plans may bundle chiropractic benefits into their policies. These can often include routine and preventive care, massage therapy and acupuncture.

Important Limitations to Know

Not All Plans Are Equal

A Medicare Advantage plan may cover some or all of the costs, but plans can vary per person and provider. Some plans may:

• Limit the number of visits per year
• Require higher copays
• Have more restrictive networks
• Need referrals from your primary doctor

Changes Year to Year

Medicare Advantage plans can change their benefits annually. According to the Centers for Medicare & Medicaid Services, plans must provide at least 45 days’ notice of any benefit changes. In 2025, some Humana Medicare Advantage plans will continue covering chiropractic care for acute and chronic conditions but will stop covering routine maintenance visits.

Stay informed about:

• Annual benefit changes
• New coverage restrictions
• Updated copay amounts
• Network changes

Tips for Maximizing Your Benefits

Choose the Right Plan

When selecting a Medicare Advantage plan, consider:

• Your current chiropractic care needs
• Preferred providers in your area
• Annual visit limits
• Additional wellness benefits

Work With Your Chiropractor

Make sure to contact all Medicare Advantage plans for reimbursement specifics prior to beginning care. Your chiropractor can help by:

• Verifying your specific coverage
• Handling prior authorizations
• Coordinating with your plan
• Explaining your benefits

Consider Supplemental Options

If your Medicare Advantage plan doesn’t cover all your chiropractic needs, you might explore:

• Discount programs for additional services
• Health savings accounts for out-of-pocket costs
• Alternative wellness programs

Frequently Asked Questions

Do I Need a Referral for Chiropractic Care?

You don’t need a referral to see a chiropractor under Original Medicare. However, if you’re enrolled in a Medicare Advantage plan, you will most likely need prior authorization.

Is There a Limit on Chiropractic Visits?

Medicare Part B doesn’t cap the number of chiropractic visits it will cover if you’re receiving manual manipulation of the spine to correct a subluxation. However, Medicare Advantage plans may set annual limits like 12 visits per year. Research from the American Chiropractic Association shows that the average patient requires 8-12 visits for effective treatment.

What if My Chiropractor Isn’t in My Plan’s Network?

You may still receive some coverage for out-of-network care, but you’ll likely pay more. Some plans have no out-of-network benefits, so check your specific plan details.

Final Thoughts

Medicare Advantage plans do cover chiropractic care and often provide more comprehensive benefits than Original Medicare. While all plans must cover medically necessary spinal adjustments, many offer additional services like routine care, X-rays, and wellness visits.

The key is understanding your specific plan’s benefits, costs, and network requirements. Take time to review your coverage options and work with your chiropractor to make the most of your benefits.

If you’re experiencing back pain or considering chiropractic care for your health needs, understanding your Medicare Advantage coverage can help you make informed decisions about your treatment options.

Ready to explore your chiropractic care options? Contact your Medicare Advantage plan today to learn about your specific benefits and find in-network providers in your area.