Is chiropractic care covered by insurance?
You may be wondering if chiropractic care is covered by insurance. The short answer is yes—most insurance plans do provide coverage for chiropractic services. However, the specifics can vary depending on whether the chiropractor is considered “in-network” or “out-of-network.” These terms can have a significant impact on both the cost of care and the type of treatment you receive. Many patients are surprised by what is covered under their insurance, even when they see an out-of-network chiropractor, and how this affects the quality of care.
But let’s take a look at in-network vs out-of-network coverage and how it affects treatment outcomes as well as comparisons in price.
Chiropractic care is an increasingly popular treatment option for musculoskeletal issues like back pain, neck stiffness, headaches, and sports injuries. Given its holistic approach and focus on spinal health, many people seek chiropractic care as an alternative to traditional medical treatments. But if you’re considering chiropractic care, you might be wondering: Is it covered by insurance?
In this post, we’ll dive into the differences between in-network and out-of-network coverage, and discuss how these choices affect your chiropractic treatment and overall results.
In-Network vs. Out-of-Network Coverage: What’s the Difference?
In-Network Coverage refers to healthcare providers who have agreements with your insurance company. These chiropractors have signed contracts with the insurer to accept specific payment rates for their services. When you visit an in-network chiropractor, your insurance typically covers a larger portion of the bill, and you are usually responsible for a smaller co-pay or co-insurance amount. However, these plans often come with restrictions on the number of visits and the type of treatments available.
Out-of-Network Coverage, on the other hand, refers to healthcare providers who do not have an agreement with your insurance company. You may have to pay a larger portion of the bill upfront, and your insurance will reimburse you for a portion of the cost. However, it’s important to understand that out-of-network does not mean not covered. Many patients are surprised to learn how much their out-of-network insurance actually covers, even if the chiropractor is not part of the insurance company’s network.
While you may need to pay more out of pocket initially, the reimbursement rates for out-of-network providers can often be higher than you might expect. Depending on your insurance plan, the out-of-network coverage may still be substantial, making this option a viable and often beneficial choice for those looking for more personalized or flexible care.
How Insurance Companies Influence Chiropractic Care
Insurance companies play a significant role in determining not only the cost of chiropractic care but also the type of care you receive. Many insurance plans—especially those involving in-network chiropractors—impose specific guidelines and limitations that may impact the treatment you get. Unfortunately, these restrictions can sometimes interfere with the chiropractor’s ability to offer the best, most effective care.
1. Limiting the Frequency of Visits
One of the most common limitations imposed by in-network insurance plans is the restriction on the number of chiropractic visits allowed. Many insurance policies only approve a specific number of sessions per year, and once you’ve reached that limit, you may be required to pay out-of-pocket for any additional treatments. These caps on care can prevent chiropractors from providing the ongoing support needed for patients dealing with chronic pain or more complex musculoskeletal issues.
This often means that chiropractors are forced to prioritize symptom management rather than long-term healing. If a chiropractor’s treatment plan is limited by insurance restrictions, they may not be able to provide the frequency of visits required for a full recovery, which can delay results.
2. Restricting Treatment Options
Insurance companies often determine which treatments chiropractors are able to use based on what is deemed "medically necessary." As a result, certain therapies and techniques that could be highly effective for your condition might not be covered. For example, advanced techniques like instrument-assisted soft tissue mobilization (IASTM) or cupping therapy may not be reimbursed under certain in-network plans, even though they could improve healing and accelerate recovery.
This limitation restricts the chiropractor’s ability to offer a fully customized treatment plan. Chiropractors may be forced to follow a more generic, insurance-compliant protocol, which can impact your overall experience and results.
3. Focusing on Short-Term Pain Relief
Due to insurance restrictions, many in-network chiropractors must focus on quick, short-term relief to adhere to the limitations of care set by the insurance company. This can result in a focus on immediate pain reduction, without addressing the root cause of the problem. Chiropractors may be unable to offer the more comprehensive, holistic care necessary to achieve long-lasting results and restore mobility, posture, and function.
Why Out-of-Network Chiropractors May Offer More Freedom in Treatment
Many patients are surprised to learn that seeing an out-of-network chiropractor can provide more flexibility and freedom in the treatment they receive. While out-of-network care might sound like it comes with higher costs, in reality, many insurance plans offer significant reimbursement for out-of-network chiropractic services.
And in many cases, the cost difference between in-network and out-of-network care isn’t as high as expected.
Here’s why seeing an out-of-network chiropractor can often be the better choice:
1. More Flexibility in Treatment
Out-of-network chiropractors don’t have to follow the same restrictions as in-network providers, which means they can offer a wider variety of treatments based on your specific needs. Without the constraints of insurance protocols, out-of-network chiropractors can provide tailored care with a focus on long-term healing rather than just short-term symptom management. They can use advanced techniques such as soft tissue mobilization, cupping therapy, or personalized rehab exercises, ensuring you get the most effective care possible.
This flexibility can make a big difference in the outcome of your treatment, as chiropractors have the freedom to design a treatment plan that is customized to your condition rather than being limited by insurance company rules.
2. Comprehensive, Long-Term Care
Out-of-network chiropractors are not restricted by insurance coverage limits, so they can provide longer, more consistent care. If your condition requires ongoing treatment over several months or even years, an out-of-network chiropractor is more likely to have the ability to accommodate this need without being limited by the number of visits allowed. This means you can receive the comprehensive care you need for sustained pain relief and functional recovery.
3. Better Results and Long-Term Relief
Because out-of-network chiropractors are not bound by insurance-imposed limits, they are able to take a holistic approach to your care. This may involve addressing movement restrictions, improving posture, using advanced soft tissue therapies, and incorporating rehabilitative exercises to restore function and prevent future injuries. By focusing on the root causes of your pain, out-of-network chiropractors are often able to provide better, longer-lasting results.
Out-of-Network Doesn’t Mean “Not Covered”
If you’re concerned about the cost of out-of-network chiropractic care, you might be surprised to find that many insurance plans offer robust reimbursement for out-of-network services. Just because a chiropractor is out of network doesn’t mean that the treatment won’t be covered.
Patients are often surprised at how much their insurance plan actually covers when they seek out-of-network care. In many cases, insurance will reimburse a significant portion of the cost, sometimes making out-of-network care more affordable than you might expect. It’s important to check with your insurance provider to find out exactly how much they will cover for chiropractic care, whether in-network or out-of-network.
The Bottom Line: Is Chiropractic Care Worth the Investment?
Chiropractic care can be an excellent option for addressing musculoskeletal issues, but whether or not it’s covered by insurance depends on the specifics of your plan. In-network coverage may be more affordable, but it often comes with restrictions that limit the type and frequency of care you receive. Out-of-network care, while potentially more expensive upfront, offers more flexibility, personalized treatment, and often better long-term results.
It’s important to understand that out-of-network care does not mean that it’s not covered. Many insurance plans reimburse a significant portion of the cost for out-of-network care, making it a viable option for those seeking comprehensive, effective treatment.
Before making a decision, review your insurance benefits and talk to your chiropractor about the best course of treatment for your needs. Whether you choose in-network or out-of-network care, understanding your options can help you make an informed choice and get the most out of your chiropractic experience.
Cruz Chiropractic and Insurance Coverage
We accept a wide range of PPO insurance plans, HSA/FSA, and offer budget-friendly self-pay options. We will always provide personalized clarity about your coverage. Before your visit, you'll receive a text, call, or email detailing your exact cost of treatment.
Some of the most common insurance providers we work with include Cigna, Aetna, Meritain, Blue Cross, United Healthcare and a wide array of student insurances.
Please be informed that deductibles and co-insurance specifics may differ among plans.
If you’d like to get started at Cruz Chiropractic, feel free to book a consult call or contact us to ask about your specific insurance coverage.
