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Does Medicare Cover Chiropractic Care?

In short, yes. However, there are some details you need to know before scheduling a visit to the chiropractor.

How Often Are Chiropractic Services Covered?

Chiropractic services are covered by Medicare when they're deemed medically necessary. Medicare Part B covers up to 80% of costs, with no maximum on the number of visits.

For Medicare, “medically necessary” generally means anything needed to treat, prevent, or diagnose any illness, disease, injury, or condition. In other words, if you are experiencing something that is debilitating or a problem for your life, it's likely to be covered.

Note that Medicare may not cover all of the services a given chiropractic center provides. Anything ‘extra' – such as product purchases not directly related to medical treatment – is unlikely to be covered. If you're not sure whether or not a given item is likely to be covered, contact your Medicare provider or ask your chiropractor for more information.

Remember, chiropractors need to be licensed by Medicare to bill them – not all Chiropractors accept Medicare.

Note: Medicare Advantage (MA) insurance plans might or might not cover chiropractic treatments. Most of these do, but payments can vary from standard Medicare rates. If you're on a Medicare Advantage plan, talk to your provider for more information.

List of Chiropractic Services

Services can vary based on your provider, so the following should not be treated as a comprehensive list. However, some treatments are common to most practices, including:

  • Chiropractic Adjustments: Adjustments focus on getting your bones (especially the vertebrae) back into position.
  • Kinesiology: Kinesiology allows a chiropractor to understand what's causing aches, injuries, or slowed healing. A session may involve testing your reflexes, checking your muscle resistance, and looking for reactions to potential allergens. This is an important part of treatment since it's difficult to create an effective care plan without knowing what the problem is.
  • Nutrition: Some chiropractic centers provide nutritional guidance. Others may directly sell health supplements to help patients in certain situations.
  • Exercise Plans: Similarly, you may be given an exercise plan to follow. As this is part of medical treatment, it's important that you follow the schedule provided. Failure to do so could slow the rate at which a problem is resolved, drive up your costs, and reduce your overall standard of living.
  • Massage: Massages may or may not be part of your chiropractic care. Many treatments include at least a small amount of massaging to loosen the body and make adjustments safer, but longer massages are available on a more location-by-location basis.

Many other services are available at some locations.

If you've received a referral to a chiropractor from your doctor, you may have been given instructions to look for specific treatments and services. Make sure the chiropractor you contact provides all of the services your doctor recommended. If no chiropractor in a reasonable distance offers those services, ask if any would be willing to offer them or talk to your doctor about an alternative care plan.

What Makes Chiropractic Care Unique

Chiropractic care works by physically adjusting your body and teaching ways to keep it in good condition. Chiropractic care isn't as fast as surgery (not counting any recovery times you may need), but it also has fewer risks of side effects than surgery and medication. This makes it one of the safest and most affordable treatment methods for certain conditions.

Other Medicare Covered Services

Medicare covers a wide variety of potential services. Options like heat therapy, electrical stimulation, and therapeutic ultrasound may be covered at a chiropractor's office.

One common service that isn't covered is acupuncture. Even if the treatment is recommended by a doctor, Medicare may not cover any of the cost of acupuncture treatments.

For more information about what is and isn't covered by Medicare, visit Medicare.gov.

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Medicare vs Medicaid: Everything You Need to Know

Each year millions of US citizens get medical funding and assistance through either Medicare or Medicaid. But how many of us actually know the difference between medicare and medicaid? Our guide will help you to discover the ins and outs of these government programs.

Medicare and Medicaid Basics

For some people, the lines between medicare and medicaid may not be clear. With similar names and the same basic purpose, many are often confused about what each program has to offer and how it works. There are many differences, however, both are programs run by the government to help citizens pay for their health care.

What is the Difference Between Medicare and Medicaid?

Medicare is primarily funded by the federal government for a majority of United States citizens and permanent legal residents who meet the designated qualifications. This is not the same for Medicaid, which is funded by both the state and federal government. Medicaid is supportive of low-income families and people who meet all of the requirements of the program.

Medicare Benefits vs Medicaid Benefits

Medicare and Medicaid have similar benefits and coverages but some people might have dual eligibility, meaning they can get both programs. If you are dual eligible the two programs can be coordinated so that your health care costs are covered.

Medicaid Covered Services

From state to state different services might or might not be included since each state runs their own program. Although each Medicaid program is different, all programs are required to have certain coverage for specific services. Medicaid.gov states that mandatory coverages include:

  • Lab & X-ray services
  • Nursing Facility services
  • Inpatient and Outpatient hospital services
  • Nurse Midwife services
  • Medical care transportation
  • Rural health clinic services
  • and more!

Other benefits that might be included in your individual state's Medicare program include prescription drugs, dental services, hospice.

Medicare Covered Services

The Medicare program comes in parts A through D which all cover different services.

Medicare Part A

Medicare part A covers any home health care, inpatient hospital care, hospice, skilled nursing facilities, lab tests and surgery.

Medicare Part B

Part B of the Medicare program (medical insurance) covers outpatient hospital care, select preventative services, medical equipment, doctor services, home health care and other health care providers' services.

Medicare Part C

Medicare Part C is supplemental plans that can be privately purchased to cover additional services that Medicare part A and B might not cover.

Medicare Part D

Prescription drugs are covered through Part D of the Medicare program. Each prescription drug plan has a different list of the drugs that are covered under each tier of prescription drug.

Who is Eligible for Medicare?

Medicare is a program that is connected with Social Security. Medicare is available to any US citizen or permanent legal resident who has been in the US for at least 5 years and is at least 65 years old. In certain situations it also may cover people with disabilities.

For those who are younger than 65 to be eligible for Medicare you must:

  • have received 2 years of SS disability benefits or a disability pension from the RRB (Railroad Retirement Board).
  • have Lou Gehrig’s disease
  • Have permanent kidney failure and need regular dialysis or a kidney transplant

If you or your spouse have worked for at least 10 years and have paid Medicare taxes you could qualify for a premium-free Part A plan. To qualify for Medicare parts C and D, you must already be enrolled in Parts A and B.

Medicaid Requirements

Medicaid is offered to low income families and individuals who demonstrate a need. Therefore this program has firm income eligibility requirements which are different depending on the state you live in.

Who Pays for Medicare and Medicaid?

Payroll taxes and SS income deductions fund Medicare parts A and B. Participants in the Medicare program pay out-of-pocket for parts C and D. As for Medicaid each individual state has the option to charge a monthly medicaid premium and to have out-of-pocket requirements. However since Medicaid is a form of public aid that is paid for by tax dollars, usually recipients pay next to nothing for healthcare.

How do I Enroll?

Whether you are about to turn 65, you are ready to retire, or need help getting health coverage you should know about all of your options and how to apply.

Medicare Enrollment

Enrollment for Medicare is only open during certain times. Sometimes some people are even automatically enrolled in Medicare when they turn 65. The 7 Month Initial Enrollment Period starts 3 months before turning 65, includes your birthday month, and ends 3 months after turning 65. It is important to know about all of your options so that when the time comes you know just what you want before applying for Medicare through Social Security.

Medicaid Enrollment

If you are wondering how to sign up for medicaid, all you have to do is fill out an application in coordination to the state you live in. Call your state’s Medicaid office to learn more details about applying and what you need to know to fill out the application. If you are accepted or even if you are not, you should fill out an application every year to renew your plan or to see if your eligibility has changed.

FAQs About Medicare and Medicaid

My Medicare card is lost. How can I get a new Medicare card?

If your card is stolen, lost or damaged you should request a card replacement from the Social Security Administration. You can do this on the website, by phone number or at your local social security office. If you have received your card through the Railroad Retirement Board, you have to go through them to get your replacement card.

What happens if I miss my enrollment window for Medicare?

If you happen to miss your 7 month initial enrollment period you will be able to enroll during the general enrollment period which is from January 1 to March 31 every year. There is a late enrollment penalty for Medicare Part B and for those who have to pay a premium with Medicare Part A.

I can’t afford Medicare’s premiums. Is there help for me?

The Medicare Savings Program pays Part A and Part B coinsurance, premiums, copays and deductibles for those with limited income. For MSP assistance qualification one must earn less than $1,245 and a couple, $1,813.

How can I find a dentist that is covered by Medicaid?

To find an office that accepts Medicaid you can use the Medicaid dental locator.

Will Medicaid pay for my Medicare deductibles and premiums?

Medicaid will pay for the coinsurance, premiums and deductibles for Medicare Parts A and B for people with low income. These people are QMBs (Qualified Medicare Beneficiaries).

What is Medicaid Planning and how does it affect eligibility?

Medicaid planning is any assistance given to a prospective Medicaid applicant in preparation for the application. Medicaid planning is often used when the monthly income of an individual is close to the financial eligibility limit. With legal help, assets are rearranged so the individual becomes eligibility for Medicaid.

Join Millions of Your Peers That Utilize Medicare Supplemental Plans

If you are a participant in Medicare or about to become one, it's important for you to understand every aspect of it, including Medigap. Despite what you may think or might have been told, Medicare does not cover everything. There are some services that aren't covered and you will have to pay additional costs like copays and deductibles. Many Americans try to lessen this by finding Medicare Supplemental Plans that will help pay for things Medicare won't.

Before the time comes to enroll, you might want to ask yourself “What does medicare cover?” and “Do I need supplemental insurance?”.

What is Medigap?

Medigap insurance policies are for those who already have Medicare Parts A and B. This helps to cover things that original Medicare does not cover. Supplemental insurances work with Medicare to help provide participants with more coverage for even less.

What is the Most Popular Medigap Plan?

Among all of the different plans the most popular supplemental plan is Medicare Supplement Plan F. Out of all the different supplemental plans 55% of all supplement plan participants are enrolled in Medicare Plan F. Medicare Plans N and C are the next popular and then Plans L and M.

How Do Supplemental Plans Work With Medicare?

Supplemental plans work along side of Medicare to provide additional assistance to participants so they can get the best healthcare possible. What many do not know before signing up for Medicare is the coverage that is offered.

Medigap Benefits and Coverage

Medigap insurance may cover hospital stays up to a year after your Medicare Part A coverage has run out. A supplemental plan might also help to cover the first three units of blood received during a hospital stay, Part A Hospice copayments and Part B coinsurance.

What Kinds of Insurance Plans are Not Considered Medicare Supplemental Plans?

When enrolling in Medicare there's a possibility that you could be automatically enrolled in other types of insurance too. Including your other types of insurance when filling out your initial enrollment questionnaire is super important in order for Medicare to decide which coverage will be used first when paying for services.

When Should You Buy a Supplemental Plan?

Every state has their own timeframes that you can buy a Medigap policy. Within most states insurance providers will only allow you to purchase a supplemental plan at certain times. Outside of this time period if you try to buy Medigap, insurance companies are legally allowed to deny you coverage, limit your coverage or charge you a higher price.

Medicare Supplement Cost

Just like other kinds of insurance each individual company sets their own prices based off of certain criteria. Researching each plan from a variety of companies helps you to understand how every company prices their policies. In general there are typically three tiers of pricing; no-age rated, issue-age rated and attained-age rated policies.

Community Rated Medigap

Community or no-age rated medigap plans calculate your monthly premium without taking into consideration your age. Anyone enrolled in this kind of plan will pay the same amount no matter their age. Inflation may cause your premium to increase, but never due to age.

Issue-Age Rated Medigap

This kind of Medigap takes into consideration the age at which you enroll into an insurance policy. So if a person enrolls right at 65 the premium would differ to that of someone who enrolls at age 72.

Attained-Age Rated Medigap

Attained-age medigap plans increase based on your current age. So when you first enroll your premium will be less and will increase as you age.

Other elements that could affect the cost of your Medigap policy include:

  • discounts offered to certain inviduals (non-smokers, married couples, etc.)
  • high deductible policy participants
  • Medicare SELECT policy holders

Medicare Supplemental Plan Eligibility

To be eligible for a medicare supplemental policy you have to first at least be 65 years of age or older. Existing enrollment in Medicare parts A and B is another requirement before you can even consider buying a Medigap plan.

Help Finding a Medigap Plan

Finding the Medigap provider and plan that is best for you can often be challenging.There are so many different options out there it might be overwhelming to find a plan. For help in your search for the right policy and to learn more about Medicare Supplemental plans, click here.

 

Cuts to Medicaid Might Drive Retirees Out of Nursing Homes

Let's get real here. In order to be a nursing home resident for the last part of your life, you need to have loads in the bank. It's not cheap to live in a nursing home these days. Which means a lot of elders rely solely on their Medicaid to pay for their nursing home expenses. Medicare and Medicaid will both pay for some nursing home care but on different terms. Medicare will only pay for 100 days and then Medicaid kicks in.

Just recently the Senate Republicans and members of the House met with suggestions of drastic cuts to Medicaid funding. The federal government requires each state Medicaid program to provide some coverage for nursing home costs. Since the state has the authority to decide how much they pay facilities, they might decide to cover less of the cost of a nursing home facility.

If they don't make the decision to decrease their payments to nursing home facilities, they might make it more difficult to meet the medical qualifications to show a need for nursing home care. In response to possible cuts, states might also change some aspects of nursing care itself and what services will be offered.

In 2015, a Kaiser Family Foundation case study shows that over half (almost three quarters) of all nursing home payments comes from Medicaid. Life expectancies are longer, but the resources are not enough to support that. This hasn't posed a problem in the past because Medicaid was there to cover the rest. What happens if Medicaid funding is decreased?

Medicaid spending on nursing homes and long term care, amounts to 42% of overall spending. Although most of the Medicaid participants are pregnant women and children almost half of the money goes towards nursing homes.

A lot of nursing home residents fear for what could happen with the talk of cutting funds to Medicaid. It's safe to say that Medicaid plays an important role in nursing home coverage and if the program changes, a lot of dominoes will fall.

Top 6 Common Misconceptions About Medicare

Medicare is one of those things that is essential to understand, especially as aging and retirement starts to settle in. With so many different myths and misconceptions about the program, it might be difficult to understand exactly what you need to know. Regardless of what you already know, the most important thing to understand is that Medicare is different than Medicaid. Here are the top 6 misconceptions about Medicare that you need to understand.

1. Medicare Covers Everything

False. Many elders are under the impression that Medicare covers every health service that you might need. There are actually a number of services that are not covered under Medicare. Routine hearing, vision and dental care are something not covered by the program. A lot of the times individuals have to enroll in a medicare supplemental plan or purchase additional insurance to cover what Medicare does not.

2. Medicare is Free

Incorrect. Probably the biggest myth about Medicare is that since it is an important government program it is free of charge. Some of the components of the program might be at little to no cost to the participant, but there are others aspects such as copays, premiums and deductibles that have to be paid.

3. At Any Point in Time, I Can Enroll

Inaccurate. Unlike other health care insurance policies, Medicare has a designated time period for any qualifying individual to enroll in Medicare. There is a 7 month Initial Enrollment Period that starts three months before your 65th birthday and lasts for three months after. Missing this enrollment period means that you will have to wait until general open enrollment begins in October each year. Sometimes you may even be automatically enrolled in Medicare when you turn 65, so it's important to keep yourself updated.

4. Poor Health History Will Make It Difficult to Get Coverage

Untrue. Since the Affordable Care Act was passed in 2010, health insurance companies are not allowed to turn individuals down based on pre-existing conditions and poor health. This is no different for the Medicare program. Medicare can not reject you because of any health conditions or problems you may have. Although you can't be declined Medicare coverage, depending on how much income you make, you could have additional charges.

5. Medicare is Not as Up to Par as Employer Group Insurance

Wrong. Both Parts A and B of the Medicare program are one of the most universally accepted forms of health coverage in the country. Out of all of the doctors, hospitals and other health care providers most of them accept Medicare. If a Medicare Advantage Plan or Part C is utilized rather than the original Medicare you may not get as big a variety of health care providers. That is why it is important to examine each plan and pick the one that works best.

6. You Can't Leave the Medicare Program

This is mistaken. After an individual has been associated with the Medicare program under certain circumstances, the participant can decline some or all parts of the plan. If you get Social Security Benefits you have to at least be enrolled in Medicare Part A.