Health insurance can be frustrating, especially when it comes to paying for chiropractic care.
...Your chiropractor prescribes 30 visits, but insurance will only cover 20...
...Your primary care doctor prescribes a chiropractic evaluation, but Medicare doesn’t cover this...
...You change jobs but under your new insurance, your chiropractor of many years is now out of network...
Health insurance companies are becoming increasingly more limited in what they will pay for regarding chiropractic care. Annual visit limitations with most insurance plans are often less than any doctor will prescribe for an injury. That means the patient is left paying for the remaining visits out of pocket. Many insurance companies, such as Cigna and Medicare, cover limited services for chiropractic, resulting in an unfair dynamic where the patient is unable to receive the same treatment as those with different insurance without paying for it out of pocket. If you are one of these patients, just know that you are not alone. Americans spend $14.7 billion per year out of pocket to complementary and integrative health practitioners, such as chiropractors, acupuncturists and massage therapists. 2
Even if you’re one of the lucky few that has a plan that pays for your entire treatment plan, no insurance company covers maintenance, or wellness care. In our office, we focus on addressing the root cause of the issue you come in with, and then keeping it at bay with regular adjustments going forward. Prevention is key - just as getting your teeth cleaned twice a year has been proven to prevent tooth decay, a host of research also shows regular adjustments can prevent spinal degeneration and keep us healthy and strong throughout our lives.3 At Carney Chiropractic Center, we encourage all our patients to be proactive about their health and continue treatment on maintenance care.
But before we can address maintaining your health, we first need to address the insurance issues that come along with getting you well. As your doctor, we want nothing more than to see you get well, but we are limited in offering discounts for services not covered by insurance
Under federal law, it is illegal for chiropractors to provide discounts for patients.
According to the Department of Health and Human Services (HHS), Office of Inspector General (OIG), "It is unlawful to routinely waive co-payments, deductibles, coinsurances or other patient responsibility payments." (67 Fed. Reg. 72,896 (Dec. 9, 2002). This applies to health care and services paid by Medicare, TRICARE/CHAMPUS, and any other program paid partially or in full with federal funds. This also includes "take what insurance pays" (TWIP) policies.1 While we want to help our uninsured and underinsured patients receive the care that they need, we also want to operate inside of federal and state regulations.
This is where the ChiroHealthUSA program can help. ChiroHealthUSA allows chiropractors to offer discounted services to uninsured and underinsured patients for their chiropractic-related expenses. “This program is exactly what doctors have been looking for to help them offer legal discounts to their patients. [It] finally provides our doctors a way to help their patients without putting their practices at risk, says Unified Virginia Chiropractic Association (VCA) President, Dr. Brad Robinson.
What is ChiroHealthUSA?
ChiroHealthUSA is a contracted network that allows doctors to offer discounted services to patients who are members of the network. It’s important to know that it is NOT an insurance program. You will still have to pay for the care you receive that is not covered by your insurance or Medicare. However, because of Carney Chiropractic Center’s participation in this program, we are legally permitted to extend special discounts on those services that your insurance will not cover.
By joining ChiroHealthUSA, you immediately become a member with no pre-approval necessary, and are eligible to enjoy discounted fees on your chiropractic care when your insurance falls short. Your membership in the program is just $49 per year and includes you and everyone in your household. It does not automatically renew, and you can cancel risk free within the first 30 days without losing any previous discounts from us.
How does it work?
Your membership allows you to access all of our services at a 30 percent discount, with a maximum fee per day, so you will always know how much it will cost before walking through the door. We also are able to extend additional discounts to those with limited services or partial insurance coverage, such as the case with Medicare patients.
Medicare only pays for the spinal manipulation performed by the chiropractor. What many patients don’t know is that Medicare will not pay for your initial exam to see the doctor, which can be costly, especially for those on a fixed income. Medicare also does not cover any physical therapy even if deemed necessary by your chiropractor. ChiroHealthUSA allows us to offer flat fees for both of these non-covered services.
This flat fee for partial coverage applies not only to Medicare patients, but other insurance patients as well. For example, you may exhaust your chiropractic benefit but have additional physical therapy benefits available. The flat fee arrangement make the visits equal to, and sometimes less than, the cost of typical copay for you. And because you have partial coverage from some services we render, we can offer discounts up to 75% off our regular fees!
As previously mentioned, no insurance company covers ongoing “maintenance” chiropractic care. Since your membership fee for ChiroHealthUSA is good for an entire year from the date you join, patients can enjoy those regular “tune up” adjustments at a 30% discount. This adds up to be about $30 per maintenance adjustment, something people can work into their budget, or even use FSA or HSA money toward.
ChiroHealth USA also offers family plan discounts, making each additional family member less expensive than the one before it. We even have a special fee schedule for pediatric care, making a family of four able to access monthly care for less than $100/month! When you join, be sure to mention any family members you want to add to your plan so we can make sure they are covered!
How can I join?
To join ChiroHealthUSA, simply complete a membership application in our office. We will collect your membership fee (you can pay by cash, credit card, or check) and submit it directly to ChiroHealthUSA. It’s an easy application, a low membership fee, and well worth joining according to the hundreds of our patients who currently use the program.
“It's so easy," says a long-time maintenance patient Michelle, who travels regularly for work and seeks adjustments after long flights. "If you are invested in regular care of your body, it makes perfect sense to use the program.”
Additional Payment Options
Carney Chiropractic Center believes in the value of wellness care for you and your family, and have maintained a pricing structure that allows care for all budgets. Our vision is to make chiropractic care a first and favorite healthcare choice in our community, so it has to be accessible! In addition to the 30% savings our patients benefit from through signing up with ChiroHealthUSA, we extend additional discounts to patients who utilize an auto debit care plan. After your initial exam, the doctor takes his findings and develops an individualized treatment plan. We then compare that plan to your specific insurance benefits and find the total cost for your treatment. We break that number up into even monthly payments, including any ChiroHealth USA discounts, and give you prepay options as well for additional savings. These auto debit care plans allow us to keep our focus on YOU and not your money.
When you sign up for a care plan, you automatically receive a 5% savings on your treatment by having the monthly auto debit option, thus eliminating excess time wasted swiping your credit card and signing for receipts after each visit. If you have a health savings account or flexible spending account that’s accumulated some funds, you may choose to pay more up front or even the whole thing, resulting in up to a 15% additional savings. Since the bulk of your treatment is in the beginning when you are in pain, it also tends to be the most expensive. Care plans are just another tool we use to make it as easy and affordable as possible for patients to access chiropractic care.
If you are concerned about the lack of coverage that your insurance company provides, or you do not have insurance, don’t let that stop you from getting the treatment that you need. Make your appointment today and let us help you sort out the coverage and payment details. Our goal is to make it as simple as possible for you to access chiropractic care and get the recommended treatment, even if your insurance is limited. We work with all major insurance plans and will fight to get you as much coverage as possible, and make your experience with us a fantastic one!
- Indest, G. F. (2012, April 5). No Good Deed Goes Unpunished for Physicians Who Extend "Professional Courtesy" or Waive Co-pays: Medicare Prohibits Waiver of Co-pays and Deductibles. Retrieved From https://www.thehealthlawfirm.com/blog/posts/no-good-deed-goes-unpunished-for-physicians-who-extend-professional-courtesy-or-waive-co-pays-medicare-prohibits-waiver-of-co-pays-and-deductibles.html
- NCCIH (2018, November 20). Paying For Complementary Care And Integrative Health Approaches. Retrieved From https://nccih.nih.gov/health/financial
- ESC. (n.d.) Spine & Degenerative Disc Back Pain or Neck Pain?. Retrieved From https://easternshorechiropractics.com/spine---disc-degeneration.html