In August of 2003, Missouri HB (House Bill) 121 went into effect.Section376.1230 provides that every policy issued by an HMO, or group insurer, shall (must) provide coverage for chiropractic care.
Since the House Bill went in to effect, we have found there are MANY exceptions: insurance companies that are home-based outside of the state of Missouri, ERISA, deductibles, and the list goes on and on. The best advice we can offer is to call your carrier and ask the following questions:
- Do I have chiropractic care on my policy?
- Is there a deductible before the insurance begins to pay for chiropractic care?
- If so, how much is it and what is applied to my deductible(100% of the charges filed?, only allowable charges?)
- Is my copay for chiropractic care going to be the same as my primary care copay?
- How many visits am I allowed in a one year period of time?
- Do I need a referral from my primary care physician for chiropractic care?
Another resource for this information is your Human Resource Department.Benefits specialists are trained to assist employees with questions relating to your particular insurance policy and the plan of coverage as it affects you.
The Doctors at St. Louis Spine and Health are providers for several companies; however, that is NOT a guarantee that your office visit will be covered by the insurance company. All insurance plans are not the same. The employer and the insurance company design and implement a plan that is right for that particular company. Therefore, you may have the same carrier (insurance company) as your best friend, co-worker or neighbor, but you will not necessarily have the same plan (or coverage).
As much as we like to accommodate our patients in every way, there are a few things we just cannot do. We do file all claims for our patients; however, we do not call the insurance company. We ask that our patients contact their insurance company prior to coming to the office. Most insurance companies use an automated system to direct your call. Because of this system and the information you are asked to provide, it is best for you to personally make those inquiry calls. There is an 800 number and a web site available on your insurance card, or you can obtain that information through your Human Resource representative.
Please contact us at 314-576-1495 for any questions you might have about insurance, thank you.