Chiropractic Coverage

[Guest kiu]

Hi, I'm interested in finding out the popularity of Chiropractic Coverage especially in the Technology Industry. Can anyone tell me where I can get the information such as the percentage of company that carries Chiropractic coverage in their employee benefit plan, etc.

Thanks

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Ming Hoe

[Guest EMK]

Popular from the employees' or the employers' standpoint? Most medium-sized and large employers have limits on chiropractic care (e.g., annual maximum benefit, number of visits maximum) and/or pay for chiropractic care at a reduced amount (e.g., 50% instead of 80%). These limits arose in the early 1980's (or at least that is when I started noticing them be added to self-insured plans) since there was some abuse in the area of chiropractic care. Fully insured medical plans may be required by state law (depending on the state) to include chiropractic care.

[Guest nb]

We've added Chiro coverage as a rider to our HMO plans. Very few problems or complaints.

[Guest kiu]

Thanks for your replies.

I have a question from nb's reply. What is the difference between having Chiro coverage in our health plan vs adding Chiro coverage as a rider to the health plan. Is there a premium difference?

Thanks.

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Ming Hoe

[KIP KRAUS]

kiu:

Adding any coverage to your health plan can affect the cost. Adding a "rider" typically relates to HMOs and maybe some PPOs, but traditional medical plans just say from some point on coverage for additional provider will be covered.

If you have an HMO they should be able to tell you the additional cost. If you have an experienced medical plan, regardless of how you are financing it costs will go up. Check with your insurer, if this is the case.

[Guest nac]

We offer a self-funded PPO and 22 HMOs.

If chiro is a separate rider under an HMO (usually as part of an alternative med rider) then we don't pick it up because there's an extra cost. However, some states mandate chiro coverage so then it's incorporated in the main plan design.

We do cover as part of our PPO plan but there is a strict review for medical necessity and the benefit is limited to 20 visits per year. We do not cover for "maintenance", which is an area of significant abuse.

It's a real hot button with our employee group but because of the expense and potential for abuse, we keep it tightly controlled.