“Will my plan pay for this?”

• Contracted with Medicare and many health plans. Your plan is checked before you book. Your card information comes in with your questions, and your plan is verified before your first visit.
• What your plan pays for: “Your health insurance plan does not define health. It defines what care it helps pay for.” Most plans pay for care of a present problem, from the time it starts until it is resolved. That care is billed to your plan; that is the office's contract with your plan.
• The care you choose: once the problem is resolved, most plans stop paying, and call the care that follows “maintenance” or “elective.” Some people stop there, and that's a real choice. Others keep coming at their own rhythm, and pay for that care themselves.
• Original Medicare: Medicare pays for one thing in this office: the chiropractic adjustment, when it treats an active problem. Medicare pays 80% after your Part B deductible; you pay 20%.
• The examination and Medicare: Medicare does not pay for the examination. If you have a secondary plan, the examination is billed to Medicare, and Medicare passes it on to your secondary plan. If your secondary plan denies it, you pay for it. Most secondary plans cover only what Medicare covers.
• Medicare Advantage: many Medicare Advantage plans also cover the examination and therapies, but not an examination on the same day as treatment. Your plan is checked before your first visit.
• Care Medicare won't cover: for maintenance adjustments, Dr. Goff reviews Medicare's notice (the ABN) with you, and you sign it only if you choose that care. Anything you pay for yourself is priced in writing first.
• Not contracted: Medi-Cal and IEHP don't cover chiropractic care in this office. You're welcome to be seen and pay for yourself.

Words like deductible, copay, medically necessary and not covered are explained in the Glossary.