Insurance Information

Is my Chiropractic Care covered by my insurance?

How insurance works

There are usually two main types of 'managed care' plans from which to choose: an HMO or a PPO. An HMO is a Health Maintenance Organization, while PPO stands for Preferred Provider Organization.

The major differences between the two plans is the cost, size of the plan network, your ability to see specialists, and coverage for out-of-network services.

When you're choosing a plan, you should consider your total health care costs, not just the monthly premium you'll pay to an insurance company every month. The premium is important, but other amounts, sometimes lumped together as "out-of-pocket" costs, can affect your total spending on your health care, and can sometimes be more than a monthly premium. Among the "out-of-pocket" costs to consider are the deductible, copayments and coinsurance, and if there is an "out-of-pocket" maximum to your plan.

The deductible is how much you have to spend for covered services before the insurance company pays for anything other than free preventive services, such as an annual physical. Copayments and coinsurance are payments you make whenever you get a medical service after you've reached your deductible.

And the "out-of-pocket" maximum is the most you'll have to spend personally for covered services in a year. After reaching it, if your plan has one, the insurance company will pay 100% for covered services.

The main differences between an HMO plan and a PPO plan are:

PPO Plans:

  • Offer more flexibility in selecting a doctor or hospital
  • Often has fewer restrictions on local therapies.
  • Sometimes covers the costs of visits to out-of-network providers.
  • The majority of companies that offer health insurance benefits to employees offered PPO plans -- 73% -- while only 37% offered HMOs in the 2018 survey.

HMO Plans:
  • Often are more affordable, with lower monthly premiums and a low or no annual deductible
  • Usually require PCP referrals to see specialists for non-emergency needs

Insurance accepted at Lightner Chiropractic

We accept BOTH HMO and PPO plans. Please check with your provider for specifics on rates and coverage.

  • Blue Cross/Blue Shield*
  • Aetna
  • Cigna
  • *Blue Cross and Blue Shield are separate companies within the state of CA
  • Medicare- does not cover elective modalities, only covers 80% of the allowed amounts for a chiropractic exam, $120 deductible for all services. Check with your plan for more information.

We also accept out of network PPO plans - contact us for more information.