Medicare Coverage and Chiropractic Care
Understanding Your Benefits and Upcoming Changes at Mid-Valley Chiropractic Allied Health Sciences
At Mid-Valley Chiropractic Allied Health Sciences, we believe patients deserve clarity and honesty when it comes to understanding their insurance coverage. This page outlines both current Traditional Medicare chiropractic coverage and the significant Medicare Advantage changes coming in 2026, so you can make informed decisions about your care.
Medicare Advantage Coverage Changes for 2026
Beginning January 1, 2026, major updates will affect Medicare Advantage chiropractic benefits in Linn, Benton, and Marion counties. These changes are being made by the insurance carriers themselves and will directly impact which plans cover chiropractic care at our facility.
Key Changes
Samaritan Health Plans will terminate all of their Medicare Advantage products.
Blue Cross Blue Shield will remove chiropractic coverage from all of their Medicare Advantage plans.
As a result, no Medicare Advantage plans offered in Linn, Benton, or Marion County will include chiropractic coverage for Mid-Valley Chiropractic in 2026.
Lane County Exception
If you reside in Lane County, PacificSource Advantage will continue to offer six Medicare Advantage plans that all include comprehensive chiropractic coverage for care at our clinic.
Our staff can help you confirm which county your plan is registered in and how these changes may affect your benefits.
Traditional Medicare Coverage for Chiropractic Care
Understanding What Medicare Covers — and What It Doesn’t
Traditional Medicare remains the only Medicare-affiliated coverage that will continue to reimburse chiropractic care at our office in 2026. However, this coverage is highly limited and has not been modernized since 1981.
Covered Services
Traditional Medicare only covers active treatment spinal adjustments deemed medically necessary. These visits must address specific spinal subluxations (the historical term used by Medicare for spinal joint dysfunction).
Non-Covered Services
Traditional Medicare does not cover:
Exams and re-evaluations
Maintenance or wellness visits
Soft-tissue therapies or rehabilitative exercises
Adjustments to the arms, legs, pelvis, or head
Because our providers use a comprehensive, evidence-based approach that includes both spinal and soft-tissue care, only a portion of your visit qualifies for Medicare reimbursement.
Exam Requirements
Medicare requires periodic examinations to justify medical necessity for continued care. These exams are not covered and must be paid in full by the patient at the time of service. Exams are required:
For all new patients
For any new injury or region of complaint
Periodically for ongoing care
Our staff will notify you when a re-exam is due to ensure your claims remain compliant with Medicare’s documentation standards.
Payment and Reimbursement Process
How Claims Are Processed Through Medicare
Mid-Valley Chiropractic is a non-participating provider with Medicare. This means:
Payment in full is collected at the time of your visit.
Our office submits your claim directly to Medicare for you.
Medicare reimburses you directly by check in the mail for the covered portion of your care.
The timing of your reimbursement is determined entirely by Medicare’s internal processing schedule.
Medicare Supplement (Medigap) Plans
If you have a Medicare Supplement (Medigap) plan, it may help cover the 20% copayment of the amount Medicare approves. However, it can only assist with services Medicare itself approves.
Medigap plans cannot pay for:
Exams
Soft-tissue therapy
Modalities or rehabilitative exercises
Maintenance or wellness visits
Our billing staff automatically submits claims to your supplement plan after Medicare processes the primary claim. If supplement payments are ever sent directly to our office, we will promptly credit or refund your account as appropriate.
Why Coverage Is Limited and Outdated
Medicare’s chiropractic policy has not been substantively revised since 1981, and it does not reflect modern, evidence-based chiropractic medicine. The current guidelines exclude many forms of care that today’s providers consider standard, including rehabilitative exercise, soft-tissue therapy, and extremity adjusting.
We remain hopeful that future revisions to the Medicare Modernization Act will expand coverage to better match the scientific and clinical standards of modern chiropractic care.
Why We Provide Complete Care
Our providers do not limit treatment to only what Medicare covers. We believe that optimal results come from treating the whole musculoskeletal system, including soft tissues and supporting structures. Restricting care solely to spinal manipulation would compromise patient outcomes and the integrity of our clinical standards.
We are committed to providing comprehensive, medically sound, and ethical care, regardless of outdated coverage parameters.
How You Can Advocate for Change
If you are affected by these limitations and wish to see change, you can contact your congressional representative to share your story. Patient feedback is essential to improving access to chiropractic care under federal programs.
Representative Lori Chavez-DeRemer
U.S. House of Representatives – Oregon’s 5th District
📍 494 State St., Suite 210, Salem, OR 97301
📞 (202) 225-5711
🌐 https://chavez-deremer.house.gov/contact
Our Commitment to You
We understand that Medicare changes and coverage restrictions can be confusing and frustrating. Our staff is here to help you navigate them.
We will continue to submit all eligible claims to Medicare on your behalf.
We will assist you in understanding your Explanation of Benefits (EOB).
We will ensure you receive any reimbursement you’re entitled to.
We will always provide clear, itemized receipts for your records.
At Mid-Valley Chiropractic Allied Health Sciences, we remain committed to transparency, professionalism, and advocacy for our patients — today, through 2026, and beyond.
Ready to Begin?
We would be honored to be part of your care team. If you’re ready to experience a massage designed around your comfort, safety, and goals, simply click “Call Now” to speak with our friendly front-desk staff, or fill out the brief contact form at the bottom of this page and we’ll reach out to schedule your appointment.
Your comfort begins with your first call — and your healing begins the moment you walk through our doors.