Understanding Your Health Insurance Benefits Coverage and Health Spending Accounts

INSURANCE

We are in-network providers for most major medical health insurance companies including but not limited to (some exclusions may apply per insurance carrier):

Aetna
BCBS
Cigna
Medcost
Medicare
PHCS
United Healthcare

If you have specific questions regarding your health plan coverage and participation, please call the member services number on the back of your insurance card and they can clarify any inquiries to your specific policy. *We will be happy to verify your chiropractic benefits when you call to make an appointment.

What types of services are covered under my insurance plan?

Most insurance companies cover chiropractic services including the different therapies and modalities offered in our center with some exceptions such as cold laser therapy and therapeutic massage.   Some plans cover acupuncture.  Benefits vary widely with each health plan.  We will be happy to verify your chiropractic benefits for the specific details about your plan when you call to make an appointment.  We also encourage you to call your carrier prior to starting care to be familiar with your own benefits.

How much do I pay when using my health insurance?

How much you will pay per visit is determined by your individual insurance coverage and is due at time of service.  Each health insurance company and plan has different benefits regarding amount of copay, deductible or coinsurance you pay, which services are covered and the number of visits allowed.   Please call the member services number on the back of your insurance card and they can clarify your specific financial obligations under your policy. We will be happy to verify your chiropractic benefits when you call to make an appointment.

When do I pay for my services?

Any copay, deductible or coinsurance are due at time of service.  Non-covered and cash services must be paid in full at time of service.

Are vitamins and supplements offered at Yeager Chiropractic covered by my insurance?

No.  But vitamins and supplements are eligible for reimbursement with a health savings account (HSA) or flexible spending account or arrangement (FSA) aka FLEX account when medically necessary.  They are typically not reimbursable through a HRA.  Please see the section below regarding health spending accounts.

Do you bill my insurance company for covered services?

Yes, we send your claims to your insurance company for covered services.  Billing your insurance carrier directly is only a courtesy extended by this office. In no way does this lessen your obligation of any charges not paid by the insurance carrier. All unpaid charges are ultimately your responsibility.

What information do you need from me to file my insurance?

In order to file a claim to your insurance, we will need to make a copy of your insurance card and your driver’s license.  Please bring your card with you to every visit.  If you decide to use your health insurance the following information is needed BEFORE your first visit:

Insurance company name (example BCBS)

Your date of birth

Your ID#

Your Group #

Toll free phone number (usually found on back of the insurance card) for Provider Services (if there is no phone # for provider services then we will need the member services phone #)

Does my insurance plan require a preauthorization?

Most plans we deal with at our office do not require a preauthorization.   Please call the member services number on the back of your insurance card to clarify if your plan requires pre-authorization for chiropractic services.  In the case where your plan does require this then pre-authorization for treatment must be obtained prior to service.

What if I have a pre-existing clause on my insurance plan?

If your insurance carrier informs us that you are under a pre-existing waiting period then payment must be made in full at time of service. When the pre-existing waiting period is over and treatment is still medically necessary then insurance benefits can be used.

*It is important to note many health insurance companies have this disclaimer when verifying benefits: “Verification of eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility, any claims received during the interim period and the terms of the member’s certificate of coverage applicable on the date services were rendered.”

HEALTH SPENDING ACCOUNTS

What are HSA, FLEX (aka FSA) & HRA accounts?

A health savings account (HSA), health reimbursement account or arrangement (HRA) and flexible spending account or arrangement (FSA) are accounts used to save on taxes and pay for qualified chiropractic, therapeutic massage, medical, prescription (including prescribed vitamins & supplements), dental and vision expenses.

Can I use my HSA, FLEX or HRA to pay for chiropractic services at this office?

Chiropractic treatment reimbursement is eligible with a standard FSA, HSA or HRA but NOT with a “limited purpose” FSA.  The limited purpose FSA is only for dental and vision expenses.

Can I use my HSA, FLEX or HRA to pay for Services that are not covered by my insurance plan?

The different non-covered services, therapies and modalities offered in our center including but not limited to therapeutic massage and cold laser therapy are eligible for reimbursement if medically necessary with a FSA and HSA but NOT with HRA.  Therapeutic massage is reimbursable with a HSA or FSA when determined to be medically necessary and with a referral from Dr. Yeager or your Physician.  

Are vitamins and supplements reimbursable through my health spending account?

Vitamins and supplements offered at our office are eligible for reimbursement with a health savings account (HSA) or flexible spending account or arrangement (FSA) when medically necessary.   They are typically not reimbursable through a HRA. 

Are special blood tests including food sensitivity tests offered at Yeager Chiropractic reimbursable through my health spending account?

Yes.  All blood, stool and urine testing offered at our office are eligible for reimbursement with a health savings account (HSA) or flexible spending account or arrangement (FSA) when medically necessary.   They are typically not reimbursable through a HRA. 

Can I use my HSA, FLEX or HRA to pay for Services for my spouse and children?

Yes.  You can use funds in your HSA, FSA or HRA to pay for eligible expenses for you, your spouse and your dependents.  However, depending on the HRA, the dependent may need to be covered by health insurance or individual health insurance.

How do I use my HSA and FSA at Yeager Chiropractic and Wellness?

Your HSA and FSA is used just like any standard debit or credit card. Present your HSA or FSA card at time of purchase and you will be able to use your pre-tax money to pay for your visit.  In the case you are asked to turn in additional documentation, receipts or a letter of medical necessity by the bank managing your account, simply contact us and we will be happy to provide the documents and receipts you require.

For additional information regarding health spending accounts, visit the Internal Revenue Service at IRS.gov or contact your employer’s human resource department.

The information on this page is intended for informational purposes only, does not purport to be complete and does not constitute tax, legal or accounting advice. Yeager Chiropractic and Wellness is not offering tax, legal or accounting advice. Anyone interested in the topics presented on this page should seek advice from his or her own independent professional advisor.