Chiro-Associates gladly accepts most health insurances. Our offices participate in many private and government health insurance programs. We also accept auto accident liens and worker's compensation cases. To find out if your insurance covers care in our office, call one of our offices directly and we will be more than happy to verify your benefits. For patients who have little or no chiropractic insurance coverage, flexible payment programs can be arranged. Considering the fact that health insurance polices frequently change, we strongly recommend that our patients contact their health insurance company to request verification of chiropractic benefits. Verification of benefits is not a guarantee that an insurance company will pay for all of the care that a given patient might require.
You can always call your health insurance companies member service line or check on-line (links below) to help verify your benefits and eligibility.
For questions regarding Health Savings Accounts please click here...
Blue Cross Massachusetts
Harvard Pilgram
Tufts Health
Medicare
Some background on Health Insurance
Health insurance is not intended to be the exclusive payer for care within any doctor’s office ; rather, it serves as a supplement.
Most health insurance companies will reimburse for a portion of your treatment. The amount of coverage is determined by the policy limits that were negotiated by the policy holder’s employer group. Unfortunately, we have no control over the terms of your policy.
When selecting a health insurance carrier and benefits plan, it is important to consider the health services that you use. If you, or the policy beneficiaries, wish to receive chiropractic care as part of the plan, pay close attention to the benefits that you will receive.
Important Terms to Know
Deductible-the annual amount that must be paid by the patient before health insurance benefits begin. Many health insurance carriers have deductibles for each family member.
Benefit period, annual versus rolling—most insurance companies reset their treatment deductible allotments via calendar year, whereas others use a rolling calendar date that begins upon the date of initial treatment.
Co-payment – payment made by the patient that represents partial payment towards services rendered. Co-payments commonly range from $0.00 to $50.00 and must be paid at the time that the service is rendered.
Co-insurance – payment that is made toward services rendered, in addition to any co-payments. It is becoming more common to see policies that have BOTH co-payments and co-insurance.
Usual and Customary Fees
Most health insurance companies will pay a set amount for a given chiropractic procedure. They refer to this as their “Usual and Customary or reasonable and customary fee. This discounted fee will be reflected on the insurance company explanation of benefits (EOB) that you receive. Although the fees that we submit to the insurance company are higher than the paid amount, it does not mean that your insurance company has been over charged, nor does it reflect the cost of delivering a given service. The “allowed” amount simply reflects the amount that the insurance company is willing to pay.
Annual Limits
Health insurance carriers typically have an annual policy limit for chiropractic services. These limits may be set by a dollar amount, or by a number of treatments. For examples, some plans have a $500 annual maximum benefit, while others allow for a set number of treatments. A commonly encountered treatment number is 12. Many research studies have shown that chiropractic care is beneficial and that it is more cost effective in the treatment of low back pain and other common musculoskeletal conditions than traditional Western medicine is. Chiropractic also lowers health care costs by focusing on prevention, was well as on treatment.
It is surprising that health insurers choose not to cover treatment that is as beneficial and cost effective as chiropractic care is. Studies have continually shown that individuals who seek the care of a chiropractor on a regular basis are healthier and, generally, spend less on health care than those who do not.
What is not surprising is that consumers are wise enough to see the advantages of chiropractic care. Many people prefer to see a chiropractor simply because they see tangible benefits from the care they receive. Many others are disillusioned with traditional Western medicine and the healthcare system, and they look for alternatives such as chiropractic care.
It is clear, both from patient testimonies and from clinical research that consumers benefit from chiropractic care. Unfortunately, they may have difficulty affording chiropractic care because it's often excluded from healthcare insurance policies.
