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Can I Use My Health Insurance?

One question patients ask frequently is “can I use my health insurance?”  The answer is “it depends”.

Insurance plans are complicated. Just because a doctor is in-network (takes your insurance) doesn’t mean your insurance will pay for your visit, and sometimes insurance pays for a visit even if the doctor is out-of-network (doesn’t take your insurance).

Below is a flowchart to help you determine if you can use your insurance when you see us. You’ll need to know your plan’s benefits (mailed to you or on your insurer’s website). Keep reading for an explanation!

What insurance do you have?
What insurance do you have?
Medicaid
Medicaid
Can I use my health insurance when I see you?
Can I use my health insurance when I see you?
Medicare Part B
Medicare Part B
Medicare Part A, C, or D
Medicare Part A, C, or D
Private insurance
(e.g., Anthem, Aetna, Cigna, etc.)
Private insurance…
Yes
Yes
No
No
Yes
Yes
No
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No health insurance
No health insura…
That’s ok! Our fees are very affordable and we offer discounts. Click here for more information.
That’s ok! Our fees are very af…
No. In Virginia, Medicaid does not cover chiropractic care. No chiropractor can take that insurance.
No. In Virginia, Medicaid d…
Only for spinal adjustments. By law, Medicare Part B does not cover
exams, adjustments on your arms or legs, physical therapy, muscle treatment, dry needling, acupuncture, or any other service when done by a chiropractor. You would have to pay cash for these treatments, no matter what chiropractor you see.
Only for spinal adjustments. By la…
No. Does not apply.
No. Does not ap…
Yes! You can use your account to pay for your visit.
Yes! You can use your acco…
Your insurance won’t cover you no matter whom you see. You may be able to
make your visits count toward your deductible, but your insurance will
only cover you after you meet your deductible.*
Your insurance won’t cover…
It may be cheaper to not use your insurance! The copay is how much you can expect to pay at every office visit when you use insurance. To compare, our follow-up visits are usually $40 ($32 with a uniformed/emergency services ID and $24 with a school ID)
It may be cheaper to not use your insuranc…
Yes, you can use your insurance but you’ll have to file for reimbursement. We can help you with that!
Yes, you can use your in…
No, your insurance will not cover you if you see us. We’re still happy to treat you! Our fees are here.
No, your insurance will n…
Do you have a Health Savings Account (HSA), Flexible Spending Account (FSA), or Health Reimbursement Account (HRA)?
Do you have a Health Savings Account (HS…
Does your plan have a deductible?
Does your plan have…
Have you met it for this year?
Have you met it for…
Does your plan require a “copay” when you see an in-network specialist?
Does your plan require a…
Does your plan cover visits to an out-of-network specialist?
Does your plan cover vi…
No
No
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*Most insurance plans cover certain visits before you meet your deductible, such as for checkups and vaccines. Visits for a condition, such as seeing a doctor because you have headaches, are not part of that.

The most common confusion we see with patients is that they didn’t know they had to meet their deductible first, even if they see a doctor who takes their insurance, and they didn’t know their copay could be more expensive than if they had paid without insurance.

If you have not met your deductible, your insurance will not cover your visit, even if you see a doctor who’s in-network (takes your insurance).

For example, say your insurance plan has a $1,000 deductible. You’ve only spent $200 at the doctor’s office so far this year. In this case, your insurance will not cover your next visit, even if the doctor takes your insurance. Your insurance won’t kick in until you’ve spent $1,000 of your own money (met your deductible).

If your insurance plan covers out-of-network provider visits, then you can use your insurance even when you see a doctor that is out-of-network (doesn’t take your insurance)! You may need to file with your insurance company first, then your insurance company will pay you instead of the doctor. Your insurance company has these forms available on their website and we’re happy to help you fill them out.

Finally, sometimes it’s cheaper to pay cash even when your insurance covers you. Many insurance plans make you pay a “copay” at each office visit. If your copay is $45, and the cash price for a visit is $40, then it’s actually cheaper for you to pay cash instead of using your insurance!

If you have questions about your benefits, we’re happy to help! Contact us and we’ll help you make sense of it all.

If you can’t or don’t want to use your insurance for your visit, our fees are very affordable and we offer discounts. See them here.

We provide the same quality care regardless of how you pay. To schedule an appointment, click here or call (804) 745-1605.