Understanding Why My Chiropractor Might Not Accept Insurance - Chiropractic and Insurance.

Affordable chiropractic care without mixing money, the market, and other variables.

This is a common question I'm asked as a chiropractor: Do I accept insurance? The short answer is no. Let's delve into the reasons behind this, starting with an exploration of why our healthcare system isn't primarily focused on health.

What's the difference between Health Care and Sick Care?

"Health care" revolves around wellness, with its primary focus being to maintain your health. This encompasses everything that aids in your journey towards health and prevents diseases from arising in the first place. It includes practices such as nutritional supplements, exercise, consuming whole organic foods, dental care, chiropractic care, massages, acupuncture, and even mental health counseling. These disciplines are geared towards averting problems before they emerge, representing an upfront investment in your health.

"Sick care" is essentially damage control. It primarily deals with emergencies such as accidents, traumas, or other life-threatening acute conditions. Managing chronic conditions like heart disease, diabetes, and cancer also falls under "sick care." The focus here is on halting the progression of diseases and ensuring that symptoms do not hinder your ability to meet basic daily needs. However, it seldom aims to pinpoint or rectify the underlying causes of illnesses. The "sick care" model tends to overlook the aspect of returning individuals to a state of health and preventing future occurrences of health issues.

What does chiropractic care have to do with insurance?

Health insurance covers treatments deemed "medically necessary," such as medication, surgeries, and treatments related to acute cases of illness or chronic conditions. Even "wellness check-ups" with a primary care physician are considered early detection of problems falling under this umbrella of necessity.

The "sick care" model is extensive and can address many of life's emergencies, but in the United States, it's also influenced by market costs and demands. As the aging population continues to grow, questions arise about the healthcare ("sick care") system's ability to support it financially. Despite being marketed as significantly more expensive, the preventative "health care" model tends to be less costly overall. This illusion is perpetuated by the lack of coverage for preventative care under insurance plans. While some wellness and preventative services may be covered, the full spectrum often isn't. These professions necessitate ongoing engagement to ensure genuine prevention efforts can occur.

For instance, a typical chiropractic office might suggest a care plan of 12 visits to alleviate your pain. This marks the initial stage of a patient's journey toward what is often termed wellness care. However, an insurance company might only cover 12 visits in total for that year. This fails to account for the subsequent stages of care, which may require 8 additional visits initially, followed by ongoing maintenance visits typically twice a month. Despite being crucial for promoting a healthy lifestyle and reducing the risk of chronic disease, these services are often not deemed "medically necessary."

Does insurance cover chiropractic care?

The answer to this question is sometimes, sort of, but likely not to the extent you would expect. I choose not to accept insurance because I prefer not to have insurance companies dictate how or when I should care for my patients, because I want to give optimal care. Generally, insurance companies offer coverage for short-term solutions as opposed to long-term preventative care because the nature of insurance is reactive. Plus, if they were to focus solely on prevention, they might struggle to stay afloat, right? Their main focus is on addressing immediate, urgent needs rather than long-term health maintenance. They concentrate on disease management and treatment, which is largely influenced by market costs and demands. This represents the traditional sick care model, heavily reliant on pharmaceuticals and surgery, which undoubtedly have their place but may not always align with holistic wellness practices.

How does insurance work for chiropractic visits?

At First Light Chiropractic and Wellness, we don't directly engage with your insurance company. This allows us to maintain lower costs and offer affordable prices, often cheaper than a typical co-pay. If you have insurance covering chiropractic care, we can provide you with the necessary documentation to pursue reimbursement from your insurance company, should you choose to file independently. However, the filing process and timeline vary from policy to policy, and I am not able to provide specific guidance on this matter.

Can I use HSA or FSA at the chiropractor?

Here at First Light Chiropractic and Wellness, we accept payments through Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) via our office system. So, yes! This is fantastic news. While insurance is invaluable for handling emergencies, it doesn't prioritize preventative measures to avoid emergencies altogether.

How can chiropractic care help prevent diseases and future health issues?

Preventative chiropractic care plays a crucial role in disease prevention by focusing on the nervous system. By alleviating strain on the nervous system, it allows the body's innate immune system to operate effectively. When there are no obstructions in the nervous system, other bodily systems can function to their fullest potential.

Visualize a river: if it's obstructed by rocks, boulders, and fallen trees, water can't flow freely. However, once these obstacles are cleared, the water can flow smoothly to its destination. Similarly, when the nervous system delivers information efficiently, the body's systems function optimally.

Enhancing nervous system function improves the body's ability to adapt to diseases, cancers, and foreign bodies. By clearing the metaphorical river of the nervous system, we boost the body's capacity to adapt and thrive.

We care about your health, and want you to care, too!

I hope this article could be informational to you about the current climate of the "health care" industry. Insurance should be used as a "break-in-case-of-emergency" plan to help you reactively cover "sick care" expenses. There is a time and place for medication, surgeries, and treatment which I am grateful to live in a time with so much innovation, technology, and understanding. But, to experience true "health care" on a consistent daily basis you must engage with preventative care disciplines to proactively sustain and cultivate health and wellness.

If you are ready to take the next steps in your journey to health you can find me at First Light Chiropractic and Wellness. I'd be honored to facilitate your healing and help guide you to the tools for a more vibrant life.

With Love,

Dr. Lily Fackrell