Visit an Aetna Chiropractor & Get Your Treatment Plan Covered by Insurance

Chiropractic Therapy / July 28, 2022
View of a desk where one set of hands is filling out health insurance paperwork across from another set of slightly blurred hands.

Are you looking for an Aetna chiropractor to receive treatment that your insurance plan covers? ChiroCare of Florida is chiropractic covered by insurance, and we accept many Aetna plans. If you’re searching for “a chiropractor near me that take insurance,” we likely have an office near you, with several locations throughout South Florida.

At ChiroCare of Florida, we provide various chiropractic treatment services to best address your needs. Whether you’re recovering from an injury, struggle with a chronic health condition, or get back and neck pain from the activities of everyday life, we’re here to help. Recover more quickly, manage your symptoms, and start living a pain-free life today when you schedule a visit.

Keep reading to learn more about whether Aetna pays for chiropractic care, why only some insurance plans cover the treatment, why many don’t include chiropractors, and how much each visit may cost.

Does Aetna Pay for Chiropractic Care?

Aetna will cover all or a portion of the cost of chiropractic care when deemed “medically necessary.” Some plans cover the treatment without having to meet strict criteria, while others state that you must meet specific requirements. To find out which scenario applies to you, call Aetna today to review your benefits and to find out how much Aetna will pay towards your treatment.

Our friendly staff can also help verify your insurance before your first visit to check your coverage and help explain the responsibility of your payment.

When asking, “Is chiropractic covered by insurance through Aetna?” you must meet the following criteria to determine medical necessity:

  1. You must have a neuromusculoskeletal disorder; and
  2. The medical need for treatment must be clearly documented; and
  3. Your Aetna chiropractor must report improvement in your condition within the initial two weeks of starting treatment.

If your provider cannot show documented improvement within those two weeks, they must show that they will modify your treatment plan to address your symptoms or condition better and how they plan to do so. Moving forward, your chiropractor must document symptom or medical presentation improvement within thirty days. In the case that they cannot provide this evidence, Aetna may stop payments and coverage and deem the treatment to be not medically necessary.

Additionally, once your medical records and documentation show that the maximum therapeutic benefit of receiving treatment from an Aetna chiropractor is reached, the insurance company will also deem the therapy to be not medically necessary.

For this reason, it’s essential that you visit an established practice that has extensive experience dealing with insurance companies. ChiroCare of Florida will help you to receive the care you need in any way we can.

Why Do Only Some Insurance Plans Cover Chiropractic Care?

Many people receive what the insurance industry calls “maintenance care” from a chiropractor. When insurance companies don’t view this maintenance care as a medical condition, they can deny benefits and coverage to patients.

Others may refer to chiropractic care as “alternative treatment,” meaning that it’s care you receive instead of standard protocol. Since chiropractors generally consider themselves a holistic treatment option, this can be detrimental to the insurance coverage process.

Additionally, insurance may deem the treatment unnecessary if you don’t have a medical diagnosis or present as asymptomatic. For many conditions, such as mental health disorders, female infertility, epilepsy, gastrointestinal issues, and more, insurance plans may consider chiropractic care “experimental and investigational.”

These are just a few reasons an insurance company may deny coverage. While some insurance plans cover chiropractic care regardless of medical necessity, others do not. This is why it’s critical to verify your benefits before starting treatment.

Why Not Many Chiropractors Are Covered

To be an Aetna chiropractor, a provider must meet specific criteria. The office must be able to perform certain diagnostic procedures to confirm that treatment is necessary. These procedures can include X-rays, radiographic mensuration, dynamic spinal visualization, the use of a nervoscope, surface scanning, and more.

Additionally, offices must provide insurance companies with adequate and detailed documentation regarding a patient’s condition, treatment plan, and progress. If a provider cannot do so, an insurance plan such as Aetna may choose not to contract with them.

Just as doctor’s offices sign contracts with insurance companies that negotiate payment rates, chiropractors must do the same. Suppose the chiropractic practice and the insurance company can’t agree on reimbursement rates. In that case, they likely won’t sign a contract to be “in-network” and won’t authorize care under patients with a specific plan.

How Much Does a Chiropractor Cost per Visit?

If you’re looking for “chiropractors near me that take insurance,” you’re also probably wondering about your out-of-pocket cost per visit. Your payment can vary significantly based on your specific insurance plan and the required criteria.

These criteria include your deductible and whether you have met it. A deductible is the amount of money you must pay for medical care before your insurance plan begins to cover a portion of the fees. After you meet that deductible, you are typically only responsible for a co-pay.

However, co-pays may also vary between insurance companies and even different Aetna plans. A chiropractor is usually considered a “specialty visit,” which can carry a higher co-pay than your primary care physician. Additionally, Aetna has different tiers of its coverage plans, and the cost of this co-pay can vary by tier. This is another crucial reason for verifying your benefits before you begin treatment.

Verify ChiroCare of Florida as an Aetna Chiropractor Today

Is chiropractic covered by insurance? The answer is not so cut and dry, though Aetna may cover the care you need. There are two easy ways to determine if you’re eligible for treatment. First, you can contact Aetna directly by calling the patient service phone number on the back of your insurance card. An Aetna representative may inquire about your medical history and the reason for seeking treatment before providing you with an answer. Or they may direct you to receive documentation from a medical provider before authorization. This can be tedious and overwhelming to some patients, becoming time-consuming and presenting red tape that you’re unsure how to overcome.

The easiest way to find out if ChiroCare of Florida, an Aetna chiropractor, is covered under your plan is to contact us. Our staff will request a copy of your insurance card, front and back, and will contact Aetna for you directly. Then, we’ll let you know whether the company will cover your treatment and what your out-of-pocket cost will be.

If you’re living in pain, don’t delay treatment. Call ChiroCare of Florida at (877) 388-2165 any time Monday through Friday from 9 am-6 pm EST to begin the insurance verification process.

Related Articles
Pair of hands holding a long, cylindrical instrument to the heel of someone else's foot.
Understanding Shockwave Therapy vs Ultrasound
At ChiroCare of Florida, our trained staff works hard to ensure that our patients are knowledgeable about our treatments. Some of the techniques we use are fairly technical or easily confused with similar techniques or methods. This is often the case with ultrasound and shockwave therapy treatment.
Hands applying a nervoscope to patient's spinal area.
Gonstead vs. Mainstream Chiropractic Adjustments
This article will clarify some of the key differences between the Gonstead and Mainstream chiropractic adjustments and will review the advantages and disadvantages of each.
Chiropractor giving a child an adjustment.
The Benefits of Pediatric Chiropractic Care
Pediatric chiropractic benefits are often a topic of discussion for parents, social media support groups, and those interested in holistic wellness treatments. Today, more and more parents are steering toward all-natural solutions to help with all aspects of their children’s lives. A quick internet search will yield thousands of results pertaining to holistic wellness and...
Get the Latest News About
ChiroCare of Florida
Subscribe Background