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MEDICARE FAQ

As a patient with Medicare it's important you understand your financial responsibility before you go through the process of making an appointment.  Please look at the chart below to determine how much of your visit will be covered and what, if any, out of pocket costs you can expect.  Medicare will not EVER pay for anything other than a chiropractic adjustment.  Medicare will not cover your first exam or any subsequent exams.  These are Medicare's rules and we look forward to the day they revise them. 

Patients are responsible to pay any out of pocket costs at the time of their visit.  We do not balance bill patients at a later date as all medicare out of pocket costs are predictable at the time of visit.  

Please come prepared to pay your balance at the time of your visit. 

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MEDICARE ONLY (Part B) 

This is a Medicare policy that includes Part B coverage. It will never have another policy name such as AARP and it will not say "medicare replacement on the card."IF YOU DO NOT HAVE PART B COVERAGE YOU DO NOT HAVE ANY COVERAGE FOR CHIROPRACTIC CARE. 

EXAM Cost Covered?

Chiropractic Adjustment Covered?

Additional Therapies Covered?

Coinsurance?

Copay?

NO, will pay out of pocket for all exams. Initial Exam: $50. Rexam $20 - $40

YES, subject to deductible

NO, will pay out of pocket on average $20 - $50 per visit. 

YES, 20% until deductible is met

NO

TOTAL COST First Visit: $50-$100 ; Second Visit: $5 - $50
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MEDICARE Replacement Policy

This is a Medicare replacement policy. The patient will not have a typical Medicare card.  This policy covers the exact same way as a traditional Medicare policy with occasional differences in copay or coinsurance depending upon the specific plan purchased.  Rehab, manual therapy, and the exam are still not covered. 

EXAM Cost Covered?

Chiropractic Adjustment Covered?

Additional Therapies Covered?

Coinsurance?

Copay?

NO, will pay out of pocket for all exams. Initial Exam: $50. Rexam $20 - $40

YES, subject to deductible or copay depending  on policy.

NO, will pay out of pocket on average $20 - $50 per visit. 

Maybe

Maybe 

TOTAL COST First Visit: $50 - $100 ; Second Visit: $5 - $50
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MEDICARE + Supplement Policy

Often Medicare patients choose to purchase an additional policy that covers the cost of their Medicare coinsurance.  These patients believe they have purchased a policy that will pick up the cost of anything Medicare doesn't cover.  This however is not the case, if Medicare will not cover the treatment, than neither will the Supplement Policy.  

EXAM Cost Covered?

Chiropractic Adjustment Covered?

Additional Therapies Covered?

Coinsurance?

Copay?

NO, will pay out of pocket for all exams. Initial Exam: $50. Rexam $20 - $40

YES, will cover entire cost

NO, will pay out of pocket on average $20 - $50 per visit. 

NO

NO

TOTAL COST First Visit: $50-$100 ; Second Visit $0 - $50
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MEDICARE + TRUE SECONDARY POLICY

Patient with Medicare and a True Secondary policy will have a Medicare card and an additional insurance card with a major insurance company such as BCBS.  This secondary card must be a PPO. Patients with the policy combination are either still employed or their spouse is still employed and is paying out of pocket for additional insurance.  This policy will cover therapies and exams that Medicare will not cover.  

EXAM Cost Covered?

Chiropractic Adjustment Covered?

Additional Therapies Covered?

Coinsurance?

Copay?

YES

YES, will cover entire cost

YES

Unlikely but possible. 

Maybe 

TOTAL COST First Visit: $0 OR Copay ; Second Visit $0 OR Copay
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