Does Humana Cover Chiropractors? Medicare, Medicaid and TRICARE Plans

Back pain, a stiff neck or a pinched nerve, and a Humana card in your wallet. Whether a chiropractor is covered depends less on Humana itself and more on which kind of Humana plan you have. Today most Humana members are on one of three: a Medicare plan, a Medicaid plan, or TRICARE through Humana Military. Each follows different rules.

First, which Humana plan is on your card?

Humana stopped selling employer health plans. In 2023 it announced it was leaving the employer group medical business, and those plans have since wound down. So if you have a Humana medical card today, it is most likely one of these:

• Humana Medicare Advantage (an HMO or PPO that replaces Original Medicare)
• Humana Healthy Horizons, Humana's Medicaid plan in some states
• Humana Military, which runs TRICARE in the East region for military families

If your card says "Humana Military" or "TRICARE", the TRICARE rules below apply, not Humana's own plan rules.

Humana Medicare Advantage plans

Every Medicare Advantage plan must cover at least what Original Medicare covers. For chiropractic care, Medicare Part B pays for one thing: manual manipulation of the spine to correct a subluxation, done by a chiropractor. It does not pay for X-rays, massage or other tests and services a chiropractor orders, and it stops paying once care becomes maintenance rather than improvement.

Some Humana Medicare Advantage plans add extra chiropractic visits on top of that, often called routine chiropractic care. Whether yours does, how many visits it allows and what you pay per visit differ by plan and county, so check your plan's Evidence of Coverage or Summary of Benefits.

Networks matter here too. Humana HMO plans usually require you to use chiropractors in the plan's network, and some need a referral. PPO plans usually let you go out of network, but you typically pay more.

Humana Healthy Horizons (Medicaid)

Chiropractic care is an optional Medicaid benefit, so your state decides whether it is covered for adults. Humana Healthy Horizons follows your state's rules and may add its own approval steps. Children and teens on Medicaid often have broader coverage when care is medically needed. Call the member number on your card and ask.

TRICARE through Humana Military

Under TRICARE's rules, chiropractic care is generally available only to active duty service members, through the Chiropractic Health Care Program at certain military hospitals and clinics. Family members and retirees usually are not covered for chiropractic care under TRICARE, even with a civilian chiropractor in the Humana Military network.

What to check on your Humana plan

• Which plan you have: Medicare Advantage, Medicaid or TRICARE
• Whether routine chiropractic visits are an added benefit, and how many
• Whether the chiropractor is in your plan's network
• Whether you need a referral or prior approval first
• Your copay or coinsurance per visit, and any deductible
• Whether X-rays or other services at the visit are covered

If chiropractic care isn't covered

Ask the clinic about a self-pay rate before your first visit; many offer one. Ask your doctor whether physical therapy, which your plan may cover differently, is an option for your pain. If a claim is denied, you can ask Humana for the reason in writing and file an appeal.

Find a chiropractor near you that accepts Humana. Tell us your plan and ZIP code, and we will match you with a nearby clinic. The clinic checks your benefits with Humana before your first visit.

Sources

• Medicare.gov: Chiropractic services coverage
• TRICARE: Chiropractic care
• Humana: Humana to exit employer group commercial medical products business