Q – What Chiropractic services does Medicare cover?
A – Medicare covers a percentage of the discounted chiropractic adjustment rate of $50.60 (Active Care Only). Other services are denied.
Q – What is the Medicare deductible amount?
A – The 2019 Deductible is $185
Q – When are Medicare claims sent out?
A – Medicare claims are sent out weekly.
Q – If I do get a reimbursement from Medicare will it come to your office?
A – No, we indicate on the claims form that we do not receive 3rd party payment, therefore patient should be reimbursed directly.
Q – Will I always be charged $50.60 for my chiropractic treatment?
A - $50.60 will be only be charged for Active Care Patients, unless otherwise modified by Medicare. Once treatment has been deemed “maintenance”, Medicare rate ($50.60) will no longer apply.
Q – What is the ABN form? Will I be asked to sign it?
A – ABN is a form Medicare requires us to present to you to inform you of the services that Medicare does NOT cover. You should never expect Medicare to reimburse you for these services. ABN is typically signed on your initial visit to the office and after you are placed under “maintenance care."
Q – I have Medicare Part A only. Will that cover me at your center?
A – No, Medicare Part A is for hospital benefits only. Part B is covered for doctor visits only.
Q – I have health insurance that is secondary to Medicare, how does that work?
A – You may have a plan that is secondary to Medicare that will pay a portion of your services. However, we only submit to Medicare on your behalf. Medicare will submit any uncovered services directly to your secondary health plan. This is call the CROSSOVER.
Q – How many adjustments per year will Medicare pay?
A – Medicare does not give a specific number on adjustments they will pay on an annual basis, however some patients have indicated they will only cover up to 20 visits.
Q – What can I expect the coverage of my secondary plan to pay?
A – See below:
- If you have a Medicare supplemental plan, this plan will only cover the difference on any services Medicare covers. If Medicare does not cover, neither does the supplemental plan.
- If your health insurance prior to participation into Medicare is now the secondary, the coverage will vary bases on the terms of reimbursement. This mean your secondary insurance may pay some or all of the uncovered Medicare reimbursement.
