Will insurance cover Chiropractic care and Functional Medicine?


That’s a great question.  In fact, that’s one of the first and most common questions people ask.  This is understandable; after all, chances are you’re paying good money for your premiums (amount you pay each month for health insurance), not to mention deductibles (amount you have to pay out of pocket before insurance pays) and co-pays (fixed amount you pay for a health care service, usually when you receive the service).  Your employer or the person that described the health insurance to you has no doubt touted the benefits of each plan, which seems generous at the time.

So where do Functional Medicine and Chiropractic care fit in?  The short answer is, I recommend that you first carefully review your policy, checking for any reference to “Chiropractic”, “preventive” services, or possibly “nutritional counseling”.  When in doubt, it’s best call your insurance company directly and ask them if any of these types of service are covered under your plan.

To understand the long answer, we must first make an introductory foray into the world of so-called “health” insurance.  The first thing that you should know about health insurance is that the term is a misnomer; your health insurance company (be it Blue Cross Blue Shield, Aetna, Cigna, Humana, or United Healthcare) has not made your health their top priority.  How can this be?

Well, let’s do a little research (I love research).  Quick Google searches show that the first Blue Cross plan was introduced in 1939.  Humana was founded in 1961.  United Healthcare is the new kid on the block, formed in 1977.  And the elder of the insurance companies?  Aetna has been around since 1853.

Since insurance companies are private corporations, this may go without saying, but it’s worth highlighting here: in order to survive, health insurance companies must turn a profit.  This is true of any company, family/household, or individual.  You must make more than you spend.  By definition, this means that they must take in (revenue) more than they pay out (expenses).  This means that their customers (that’s you) must pay more in premiums (as well as deductibles and co-pays) than they pay back out on your behalf (in the form of benefits, or covered services).

Functional Medicine itself requires the doctor to spend an enormous amount of energy behind the scenes between your appointments.  This time spent on your behalf includes deeply interpreting lab results and putting them together, attempting to find the underlying common cause or causes of the problem.  This may also take research and review of the newest published studies as they come hot off the presses.  No other healthcare discipline goes this far or invests this amount of time on each patient. We are also a rehab-focused chiropractic clinic, so we put extra time into tailoring exercises specific to each patient so their recovery is faster.

We are all gifted with the same amount of time each day. I am called and passionate about caring for patients in a way that addresses their symptoms AND the cause of their symptoms. This is unique, special and takes extra time to research, review your case, prepare information and treatment plans, and answer your questions. Because of the extra challenges that surround dealing with insurance companies, most functional medicine doctors and some chiropractors don’t submit insurance claims on behalf of their patient. We are also unique in this regard because we do. It is a convenience that we kindly offer to our patients.

We also can provide a descriptive receipt that patients with Flexible Spending Accounts (FSA) can turn in to receive reimbursement of their healthcare expenses. We can never guarantee this, as insurance companies are like water, always changing and tough to get a firm grasp of.

The common scenario is this: you start to feel that something’s not quite right.  You visit your conventional/regular doctor, who runs the blood tests and, after scanning them quickly, says “everything is normal”.  You know that it’s not, but now they’re hinting that it’s all in your head.  Meanwhile, your health does slide further and further away from healthy ranges, toward the outlying borders of “normal” and eventually it does cross into “abnormal” territory.  This may be years later, and by then it may or may not be too late to effectively use natural methods.

That’s where Functional Medicine and Chiropractic care comes in, and hopefully you’ll be able to see us before you reach the disease point.  With any luck, your insurance company will cover at least part of the tab.  If they do, look at it as a secondary bonus, and if they don’t, simply consider it part of the cost of living.  After all, when owning a vehicle, we understand that if we don’t invest in maintenance, the car breaks down and stops working.  We must pay for regular oil changes, state-mandated vehicle inspections, license plate tags/stickers, brake pads (which are actually designed to wear out!), tires, and many more.  Why give your body any less?  Make your health your top priority, even if it’s not your insurance company’s.  Why?  Because you only have one body, and it only treats you as well as you have treated it.  When you are feeling at your best you are able to serve your family and others to your fullest potential and live more of an Abundant Life. We’re a product of the decisions we have made every day.  Up until now, people have relied on their insurance coverage for any kind of medical care.  But if we want a different result, we may have to consider a different approach…whether an out-of-touch insurance company thinks it’s medically necessary or not 🙂

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