One common question that arises is whether chiropractic care is covered by Medicare. The short answer is yes, but with specific conditions. In this article, we’ll delve into the details of Medicare coverage for chiropractic services and what you need to know.
Chronic Disease Management Care Plan
Chiropractic services and other allied health services are not directly covered by Medicare in the same way that medical doctor visits or hospital stays might be. Instead, Medicare provides coverage for chiropractic care through the Chronic Disease Management (CDM) care plan. This plan is designed to help individuals manage chronic conditions more effectively by offering a structured approach to care.
To access chiropractic services under the CDM care plan, patients must first consult with their local general practitioner (GP). The GP will assess whether the patient’s chronic condition would benefit from allied health services, such as chiropractic care. If the GP determines that chiropractic care is appropriate for managing the chronic disease, they can refer the patient for up to five consultations with a chiropractor or another allied health professional.
To qualify, patients must have a chronic disease or condition that their GP believes could benefit from allied health services like chiropractic care. Chronic diseases are long-lasting conditions that require ongoing management and may include conditions such as arthritis, diabetes, or chronic back pain, among others.
While the CDM care plan allows for up to five consultations with a chiropractor, patients should be aware of the financial implications. Medicare provides a rebate of approximately $50 per consultation, which helps offset the cost of chiropractic services. However, it’s essential to check with individual chiropractors regarding their fees and any out-of-pocket expenses that may apply.
In summary, chiropractic care is covered by Medicare but only under specific conditions through the Chronic Disease Management care plan. Patients with chronic diseases who may benefit from chiropractic services can consult with their GP to determine eligibility and obtain a referral. While Medicare provides a rebate for up to five consultations, it’s essential to consider any additional costs and consult with healthcare providers to make informed decisions about managing chronic conditions effectively.