Fidelis Medicaid provides coverage for chiropractic services, although availability depends on your specific plan. To find out if your plan includes chiropractic care, you can check your plan benefits or contact Fidelis member services. If chiropractic coverage is included, you may need to obtain a referral from your primary care physician before you can see a chiropractor. There may also be limits on the number of chiropractic visits covered each year. Fidelis Medicaid wants to ensure that its members have access to comprehensive healthcare services, and chiropractic care is an important part of that.
Fidelis Medicaid: Chiropractic Coverage
Fidelis Medicaid provides coverage for chiropractic care services. This coverage includes:
Covered Chiropractic Services:
- Spinal manipulation
- Diagnosis and treatment of neuromusculoskeletal conditions
- Patient education and counseling
- Rehabilitation and physical therapy
- Nutritional counseling
- Home exercises and stretches
Limitations and Restrictions:
- Coverage is limited to 12 visits per calendar year.
- A referral from a primary care physician is required for chiropractic services.
- Chiropractic services are not covered for conditions that are considered to be cosmetic in nature.
Prior Authorization:
Some chiropractic services may require prior authorization from Fidelis Medicaid before they are covered. This includes services such as:
- Spinal manipulation for conditions other than low back pain.
- Chiropractic care for children under the age of 18.
- Chiropractic care for pregnant women.
How to Find a Chiropractor:
To find a chiropractor who accepts Fidelis Medicaid, you can:
- Contact your primary care physician for a referral.
- Check the Fidelis Medicaid website for a list of participating providers.
What to Expect at Your First Appointment:
When you visit a chiropractor for the first time, you can expect the following:
- A complete medical history will be taken.
- A physical examination will be performed.
- The chiropractor will discuss your condition and recommend a treatment plan.
- The chiropractor may also provide you with information on exercises and stretches that you can do at home.
Cost of Chiropractic Care:
The cost of chiropractic care covered by Fidelis Medicaid varies depending on the type of service provided. However, copayments and deductibles may apply.
Benefits of Chiropractic Care:
Chiropractic care can provide a number of benefits, including:
- Relief from pain
- Improved range of motion
- Reduced inflammation
- Increased muscle strength and flexibility
- Improved posture
- Improved overall health and well-being
If you are experiencing back pain or other neuromusculoskeletal problems, talk to your doctor to see if chiropractic care is right for you.
| Service | Coverage | Limitations |
|---|---|---|
| Spinal manipulation | Covered | 12 visits per calendar year |
| Diagnosis and treatment of neuromusculoskeletal conditions | Covered | Referral from primary care physician required |
| Patient education and counseling | Covered | None |
| Rehabilitation and physical therapy | Covered | None |
| Nutritional counseling | Covered | None |
| Home exercises and stretches | Covered | None |
Eligibility Requirements for Fidelis Medicaid Chiropractic Coverage
Eligibility for Fidelis Medicaid chiropractic coverage is determined by several factors, including:
- Age: Children under 21 years of age are eligible.
- Income: Families must meet the income eligibility guidelines set by the state of New York.
- Pregnancy: Pregnant women are eligible.
- Disability: Individuals with disabilities may be eligible.
- Other factors: Additional factors, such as being a U.S. citizen or a legal resident, may also be considered.
To apply for Fidelis Medicaid, you can visit the New York State of Health website, call the Fidelis Care customer service line, or apply in person at a local Department of Social Services office.
If you are eligible for Fidelis Medicaid, you will receive a Member ID card that you can use to access chiropractic services. You can find a list of participating chiropractors on the Fidelis Care website.
Benefits Included in Fidelis Medicaid Chiropractic Coverage
Fidelis Medicaid chiropractic coverage includes a variety of benefits, including:
- Chiropractic adjustments: This is the most common type of chiropractic treatment and involves the chiropractor using their hands to manipulate the spine.
- Spinal manipulation: This is a more specific type of chiropractic adjustment that uses a specific instrument to manipulate the spine and help correct spinal misalignments.
- Massage therapy: This can help to relieve muscle pain and tension.
- Acupuncture: This is a traditional Chinese medicine technique that involves inserting thin needles into the skin at specific points on the body.
- Physical therapy: This can help to improve range of motion and strength.
Limitations of Fidelis Medicaid Chiropractic Coverage
There are some limitations to Fidelis Medicaid chiropractic coverage, including:
- Number of visits: There is a limit on the number of chiropractic visits that are covered each year.
- Copays: There is a small copay for each chiropractic visit.
- Prior authorization: Some chiropractic services may require prior authorization from Fidelis Care before they are covered.
How to Use Fidelis Medicaid Chiropractic Coverage
To use Fidelis Medicaid chiropractic coverage, you can follow these steps:
- Find a participating chiropractor: You can find a list of participating chiropractors on the Fidelis Care website.
- Schedule an appointment: Call the chiropractor’s office to schedule an appointment.
- Bring your Member ID card: When you go to your appointment, bring your Fidelis Care Member ID card with you.
- Pay your copay: You will be responsible for paying a small copay at each visit.
- Receive your treatment: The chiropractor will provide you with the chiropractic treatment that you need.
Fidelis Medicaid Chiropractic Coverage Summary Age: Children under 21 years of age Income: Families must meet the income eligibility guidelines set by the state of New York. Pregnancy: Pregnant women are eligible. Disability: Individuals with disabilities may be eligible. Benefits: Chiropractic adjustments, Spinal manipulation, Massage therapy, Acupuncture, Physical therapy Limitations: Number of visits, Copays, Prior authorization How to Use: Find a participating chiropractor, Schedule an appointment, Bring your Member ID card, Pay your copay, Receive your treatment Covered Services Under Fidelis Medicaid
Fidelis Medicaid is a health insurance program that provides coverage for low-income individuals and families in New York State. Fidelis Medicaid covers a wide range of medical services, including chiropractic care.
Chiropractic Care Covered Services
Fidelis Medicaid covers the following chiropractic services:
- Evaluation and diagnosis of neuromusculoskeletal conditions
- Chiropractic manipulation of the spine and extremities
- Physical therapy modalities such as heat, cold, and electrical stimulation
- Therapeutic exercises
- Patient education and counseling
Fidelis Medicaid does not cover the following chiropractic services:
- Routine maintenance care
- Services that are not medically necessary
- Services that are provided in a hospital or skilled nursing facility
How to Get Chiropractic Care Covered by Fidelis Medicaid
To get chiropractic care covered by Fidelis Medicaid, you must first find a chiropractor who accepts Fidelis Medicaid. You can do this by searching the Fidelis Medicaid website or by calling the Fidelis Medicaid customer service number.
Once you have found a chiropractor who accepts Fidelis Medicaid, you will need to schedule an appointment. At your appointment, the chiropractor will evaluate your condition and determine if chiropractic care is right for you. If chiropractic care is right for you, the chiropractor will develop a treatment plan.
Fidelis Medicaid will cover the cost of your chiropractic care up to the limits of your policy. You may be responsible for a copayment or coinsurance.
Table Summarizing Chiropractic Services Covered by Fidelis Medicaid
Covered Services Not Covered Services - Evaluation and diagnosis of neuromusculoskeletal conditions
- Chiropractic manipulation of the spine and extremities
- Physical therapy modalities such as heat, cold, and electrical stimulation
- Therapeutic exercises
- Patient education and counseling
- Routine maintenance care
- Services that are not medically necessary
- Services that are provided in a hospital or skilled nursing facility
Fidelis Medicaid Managed Care Plans
Fidelis Care offers several Medicaid Managed Care plans that provide comprehensive healthcare coverage to eligible individuals and families. These plans include:
- Fidelis Care Community
- Fidelis Care Medicare Advantage
- Fidelis Care Essential
- Fidelis Care Plus
- Fidelis Care KidCare
Chiropractic Care Coverage
Fidelis Medicaid Managed Care plans generally provide coverage for chiropractic care, including:
- Spinal manipulation
- Mobilization
- Rehabilitation exercises
- Other chiropractic services deemed medically necessary by a licensed chiropractor
Coverage for chiropractic care may vary depending on the specific plan and the member’s individual needs.
Prior Authorization Requirements
Some Fidelis Medicaid Managed Care plans may require prior authorization for chiropractic services. This means that the member must obtain approval from the plan before receiving the service in order for it to be covered.
Prior authorization is typically required for services that are considered elective or experimental, or for services that are expected to exceed a certain cost threshold.
How to Obtain Coverage
To obtain coverage for chiropractic care through a Fidelis Medicaid Managed Care plan, members should:
- Contact their plan to determine their coverage for chiropractic care.
- Find a chiropractor who is in-network with their plan.
- Schedule an appointment with the chiropractor.
- Bring their Fidelis Medicaid Managed Care ID card to the appointment.
Benefits of Chiropractic Care
Chiropractic care can provide a number of benefits, including:
- Relief from back pain, neck pain, and other musculoskeletal pain
- Improved range of motion
- Reduced inflammation
- Improved overall health and well-being
Table of Chiropractic Coverage by Fidelis Medicaid Managed Care Plans
Plan Chiropractic Coverage Prior Authorization Required Fidelis Care Community Covered No Fidelis Care Medicare Advantage Covered Yes, for services exceeding $500 Fidelis Care Essential Covered Yes, for services exceeding $300 Fidelis Care Plus Covered No Fidelis Care KidCare Covered Yes, for services exceeding $200 And that’s a wrap! I hope you found this article informative and helpful in understanding whether Fidelis Medicaid covers chiropractic services. If you have any further questions or concerns, don’t hesitate to reach out to Fidelis Medicaid directly. Thanks for reading, and be sure to visit again later for more insightful content like this!