Will Medicare cover my Chiropractic sessions?
At least once a week, a patient will ask us “Does Medicare cover Chiropractic?” and we are happy to tell them that the answer is yes.
As part of your Medicare coverage you are entitled to up to five chiropractic visits a year fully paid for by Medicare. This is organised by your GP through a Chronic Disease Management plan (CDM) or Team Care Arrangement (TCA).
This coverage can save you over $250 in health care costs. Unfortunately many people who are eligible for this plan don’t even know that it exists.
Who is Eligible?
You are eligible if you have a chronic condition and you have a Medicare card. Your GP will create a specific chronic disease management (CDM) plan for you and they can then refer you to a chiropractor on a team care arrangement (TCA) for up to 5 visits.
How Do I Get a Referral?
First you will need to consult your GP about your specific conditions and discuss with them your eligibility for chiropractic care under a CDM plan.
If you are eligible your GP will send us your TCA referral and we can then make a time for you to come in for your first visit.
Is There Any Cost To Me At All?
Yes, you will need to pay the “gap fee” of $36.20 each visit.
What Is A Chronic Condition?
A chronic condition is defined as a condition that has been present for six months or longer.
It’s important to remember that while you may be suffering from acute low back pain, neck pain or a headache that has only be present for a few days, often the underlying cause is a chronic problem that you are not aware of.
What Conditions Are Eligible?
Any condition that is chronic and complex is covered by Medicare through the CDM program. The most common conditions that we see are
- Low back pain
- Neck pain
- Headaches
- Sciatica
- Bulging and Prolapsed Disc Injuries
- Pain from Arthritis/ Degenerative Joint Disease