Health insurance for chiropractic treatment

If you struggle with pain in your joints, chiropractic care could help you out.

Chiropractic therapy is designed for spinal health. It’s a fairly common treatment for cases that involve lower back pain, chronic conditions and sprains.

Medicare and private health can help reduce the cost of treatment.

What is a chiropractor?

A chiropractor can help align your spine and joints by using hands-on manipulation. They do this to treat musculoskeletal problems that can cause pain or affect how you move. Chiropractors may adjust your spine or joints by using specific force, instruments or indirect pressure, depending on what they are treating.

Chiropractors can treat a range of issues, from headaches to major back injuries.

What to expect when you visit the chiropractor?

When you walk through the door at your first appointment you’ll have to fill out some paperwork on your health. You’ll then have a consultation with your chosen chiropractor who will work through an examination of what’s causing you issues. They will typically look at:

  • Medical history
  • Vital signs (such as blood pressure and breathing rate)
  • Posture
  • Range of motion
  • Musculoskeletal condition
  • Nervous system

You may also be referred for an X-ray to get a little more insight into the structure of your spine. If you already have these from your GP, it could be worth taking them with you.

You’ll then be set up with a treatment plan, which involves specific spinal adjustments. You may also get some home exercises to practice outside of the session.

Common techniques include:

  • Spinal manipulation
  • Mobilisations
  • Stretches
  • Massage
  • Orthotics
  • Lifestyle advice

How much does it cost to visit a chiropractor?

The cost of visiting a chiropractor can vary depending on who you see, but generally, there will be two different costs. Most chiropractors will charge an initial consultation fee that may be between $70 and $140. After the initial consultation, the price of a visit may be between $40 and $60 each time.

You’ve got three different options when it comes to paying for treatment:

  1. Pay all fees out of pocket
  2. Get extras cover to provide ongoing treatment discounts
  3. Get five free sessions from Medicare

Let’s dig into these a little further.

How does health insurance cover chiropractic treatment?

Chiropractic services may be included as part of your health insurance extras cover.

Before you can claim any services you may need to complete a waiting period of two months, sometimes more. The amount you can claim for your chiropractor will depend on your health insurance plan. There is generally a limit to how much you can claim each year, $300 for example.

Your insurer will most probably pay a percentage of your fee for each visit until you reach the total limit for the year. For example, if your initial consultation is $100 your insurer may pay you for 60% of the cost leaving you with an out-of-pocket expense of $40.

Alternatively, you may get a set refund per session, such as $20 per hour.

Here’s a summary of how those costs would compare with and without private insurance over time. In this case, saving you $188 over 8 treatments.

Treatment cost With extras cover
Visit 1 $120 $72
Visit 2 $50 $30
Visit 3 $50 $30
Visit 4 $50 $30
Visit 5 $50 $30
Visit 6 $50 $30
Visit 7 $50 $30
Visit 8 $50 $30
Total treatment cost $470 $282

It’s also a good idea to check whether your health insurer has a preferred provider before you see a chiropractor just to be sure that it will cover your claim. If you already have someone in mind, it’s best to check if they take HICAPS payment, as you can then use your private health insurance card to get an on-the-spot discount.

Is it worth it?

It’s actually pretty easy to get value from extras cover if you use other services included in your monthly payment. If you’re just looking for a few sessions then the cost of extras could outweigh your treatment discounts. It’s also worth noting you can’t use Medicare and private health insurance together.

However, if you need regular treatment or can make use of other included services (typically dental, physio and optical) then an extras policy can be a great way to reduce your treatment costs.

Below are a few options from Finder partners that include yearly limits for chiropractic, the prices are based on a single living in Sydney. All have a 2-month waiting period:

Annual limit What's covered Features Monthly cost Apply
ahm logo

Black 50 saver

$300 50% of cost
  • Chiropractic limit is combined with physiotherapy and osteopathy
  • Also includes $400 limit for general dental
$12.85 Go to site
HCF logo

Vital Extras

$250 $40 back for first visit; $33 back for each subsequent visit
  • Combined limit with osteopathy and dietetics
  • Also includes $800 general dental and $250 optical
$56.35
Go to site

*Quotes are based on less than $90,000 income.

How does Medicare cover chiropractic treatment?

Medicare can help with chiropractor costs for up to five visits a year if you suffer from chronic pain. To claim, you need to speak to your GP about a Chronic Disease Management plan (CDM) or Team Care Arrangement (TCA).

This could save you between $200 and $500 over the course of 5 sessions.

A chronic condition is defined as a pain or injury that you’ve had for six months or longer. Commonly these can include:

  • Headaches
  • Lower back pain
  • Neck and shoulder pain
  • Sciatica
  • Knee pain
  • Strains
  • Arthritis

If you are not eligible for a CDM plan or TCA, you either have to pay full price or get private health insurance.

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Picture: Unsplash, Shutterstock

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