Chiropractic care is an essential medical service that can be used by patients with a wide array of health conditions. Some use it to treat issues with arthritis, osteoporosis, injuries resulting from car accidents, and back pain. Others find it to be an excellent choice for preventing musculoskeletal problems down the road.
Readjusting your spine and neck can help alleviate tension and prevent issues caused by bad posture and sedentary lifestyles. Those who sit many hours daily for work can especially benefit from chiropractic care as a preventive service.
But whatever your reasons for using a chiropractor, you may be wondering if your health insurance under the Affordable Care Act will cover the services rendered.
According to the Affordable Care Act, health insurers are required to offer policyholders a set of EHBs, or essential health benefits. This defines the type of benefits that need to be offered to policyholders, but it doesn’t specify exactly which services have to be included.
Under the list of EHBs, chiropractic care isn’t specifically included. However Obamacare does allow states some flexibility to define the specifics of services to be offered in their set of EHBs. These are then found in the health insurance plans within the state health insurance exchange. Under Obamacare, states are able to select a benchmark plan that will act as a model for all the health plans that are included in its exchange for both small group and individual markets.
There are a variety of plans you can find in the health insurance marketplace that provide coverage for chiropractic care. However, it is not a requirement of the ACA so there are other plans that don’t include chiropractic care.
Those that do offer chiropractic care normally restrict how many visits to a chiropractor you can have annually. It’s also based on your medical need for the services. So if you’re receiving chiropractic care after an auto accident and are seeing improvements, then your care will be covered within the maximums the policy sets.
Rehabilitation and Habilitation Coverage
You can find services related to physical therapy found inside of the EHBs, which are listed under rehabilitation and habilitation. Rehabilitation is a service that helps individuals return to or improve their skills, so they can properly function in daily living. This is provided to patients that have lost their mobility and motor skills due to an accident, illness or disability. Services normally included in this category include speech-language pathology, occupational therapy, psychiatric rehabilitation and physical therapy. These can be obtained from inpatient and outpatient centers.
Habilitation services are designed to help people improve, keep or learn skills and functions that enable them to perform daily tasks. This is normally reserved for children who have difficulties walking or talking. Services included in this category include speech-language pathology, physical therapy, occupational therapy and a variety of others, which can be obtained in an inpatient or outpatient clinic.
Rehab services are mandatory with most QHPs, or Qualified Health Plans. However, some states restrict the number of visits annually or have caps and other limitations that apply.
If you’re looking for chiropractic care in your health coverage, make sure to read the fine print to see if the medical services you need will be covered.
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