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According to the American Chiropractic Association, approximately 35 million Americans go to a chiropractor every year. This type of care is particularly helpful for treating back pain resulting from a car accident, work or exercise-related strain or an injury, or just needing relief. Seeing a chiropractor can be expensive, but fortunately, most health insurance companies provide coverage to treat medically needed care.
The Affordable Care Act includes 10 categories of essential health benefits that all major health insurance plans are required to provide. Among these benefits is coverage for habilitative and rehabilitative services that help those with injuries or illnesses regain physical skills.
While this does not expressly include chiropractic care, most health insurance plans cover this treatment option sometimes referred to as “manual manipulation”. Generally, there will be limits to the number of visits that will be covered in a year, depending on your health insurance plan. It’s estimated that roughly nine out of 10 employees have chiropractic care covered under their employer-subsidized health insurance. In some cases, health insurance companies require policyholders to get referrals from their doctors before making an appointment with a chiropractor.
While your health insurance company may cover short-term chiropractic care to treat a specific injury, it probably does not cover maintenance care, or care that you get on a regular basis to maintain your health rather than treat a condition. That is because many health insurance companies do not see maintenance chiropractic care as a medical necessity. While they may cover care to help policyholders recover from an injury, they are unlikely to cover services that do not have a clear benefit or bring about signs of improvement. Some plans may cover “Manual Manipulation” which applies to Medical-Physician Services and Chiropractic office visits. As stated above, these benefits may be subject to a maximum benefit of twenty (20) visits per insured per calendar year. You will need to look at your individual plan’s “Summary of Benefits” guide or “Agreement of Coverage” to verify these benefits.
While most insurance companies provide coverage for chiropractic care, there are several ways in which they limit coverage. Rules vary from one plan to another, but in general, most health insurance companies limit how many times you can visit your chiropractor over the course of a month or year. For example, your plan may cover 20 visits per year, and you may have to obtain care within a certain time-frame. As is the case with general care practitioners and specialists, some health insurance companies require that you see in-network or approved chiropractors. They may also require that you get a referral from your doctor to see a chiropractor, and they may require your doctor to create and follow a care plan.
Your insurance company may place additional limits on chiropractic care. Talk to a licensed health insurance agent if you are not sure how your plan covers this type of service.
Finding a health insurance policy that covers the care you need and fits within your budget can save you a lot of money in the long run. At Nevada Insurance Enrollment, our health insurance agents are experienced in helping Nevadans assess their needs and find the best health insurance plan at an affordable monthly rate.
Most people have never heard of association health plans; however, these health insurance plans have been around for decades. Association Health Plans may have fewer benefits but will most likely have lower premiums, making them an attractive option for those who are young, healthy, and on a budget.
According to a recent study, health insurance premiums could increase for individual plans on the ACA marketplace between 35 and 94 percent by 2021. Concern over health care is nothing new; in fact, this is the fifth consecutive year that Americans have ranked health care as a top concern.
At least for now, many aspects of ACA are still in place. Currently, an insurer can’t turn you away for a pre-existing condition, and long-term health insurance plans still have to provide coverage for ACA’s 10 essential health care benefits. Prior to 2010, private health insurance usually did not cover maternity, or preventative like it does now, and mental health was generally non-existent.
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We HIGHLY recommend you double check that your physician will take the Nevada Health COOP plan you are enrolling into.
Those who gained coverage made 40 percent more visits to the emergency room than their uninsured counterparts during their first 18 months with health insurance
Anyone who can show that their individual or family policy has been cancelled, will be eligible to buy a “catastrophic” plan through the Nevada Health Link.
Changes to the way medical billing works will be coming on Oct. 1, 2014. The health care medical billing system will change over to a new computerized system.