Dear Practice Member,

Changes in the insurance industry and chiropractic coverage have prompted me to write this notice. For example, since April 2006, Blue Cross has established a policy that does not and will not cover supportive, maintenance, or wellness care. Further, their policy states that they will only cover treatments for acute pain relief. In their words:

“BCBS does not reimburse for those categories of chiropractic services commonly described as ‘maintenance care,’ ‘wellness care,’ ‘supportive care,’ or ‘preventive care’. Medically necessary chiropractic services are limited to those manual and physical medicine services for which there is a defined acute or initial therapeutic
care plan.”

 “Wellness or preventive care is typically rendered on a regular or periodic basis to help maintain optimal body function, often when there is little or no activity-restricting symptomatology. Palliative or supportive care is usually given after chronic symptoms have become stationary after the completion of an initial course of therapeutic care. Ongoing care after the condition has stabilized or a patient’s condition has reached a clinical plateau… does not qualify as medically necessary.”

In other words, ALL insurance companies will only cover treatments for what we call “band-aid care”. Treatments are covered only until your pain is gone. However, pain is only a symptom and not the problem. Unfortunately it may take several more visits to restore function, heal ligaments, improve muscular imbalances, teach exercises, etc. Once your pain is gone and your visits are about every 2 weeks or less often (ex.: once per month, etc.), your visits will NOT be covered by your insurance company. You are responsible. Those visits are termed supportive, maintenance, wellness, or preventive care and will not be covered by your insurance company. Again, You are responsible.

Realize that what our culture calls health care is actually “sick” care, since it has little to do with advancing true health. It is mostly about suppressing symptoms while ignoring the underlying cause. Now, if you have a policy it will probably help with at least some of the expense of your sick care. But few policies pay for things that help us keep our health. For example: Many policies will pay for expensive back surgeries, but won’t pay for a program of ongoing chiropractic care that costs less, and could actually help prevent back surgeries!

Consider this. Many of us who value our health, drink bottled water. We believe it’s healthier for us. Is our bottled water covered by insurance? No. And, every day, millions take vitamins and some other nutritional supplements. We believe they help support our overall health and well-being. Now, do HMOs and insurance companies pay for vitamins? Not that I know of.

It’s clear that insurance companies don’t “get” the value of vitamins, bottled water, exercise equipment, health club memberships, chiropractic care and countless other strategies that more and more of us use to enhance our health and vitality.