So you’re sitting there with your Aetna insurance card wondering if your back pain is covered. Been there. Had a patient last week from Cherry Creek who’d been putting off treatment for months because she wasn’t sure if her Aetna plan would cover chiropractic care. Turns out it did and she could’ve been feeling better way sooner.
I’ve been working with Aetna patients here in Denver for over 14 years now. And frankly? The insurance stuff can be confusing. But here’s the good news – most Aetna plans do cover chiropractic care. You just need to know what you’re looking for and how to use your benefits.
Short answer – usually yes. Most Aetna plans include chiropractic coverage. But like everything with insurance there’s always a “but.”
Most Aetna plans cover chiropractic with no referral needed. Some have a copay. Some have a deductible you need to meet first. And some limit how many visits you can have per year.
I know it’s annoying. We deal with this stuff every day.
The most common Aetna plans I see in Denver are Aetna PPO, Aetna HMO, Aetna Open Access, and Aetna Medicare Advantage. Each one works a little differently when it comes to chiropractic benefits.
Here’s what I tell people – call the number on the back of your Aetna card and ask these specific questions:
Write down the answers. Get a reference number for the call. Because sometimes what they tell you on the phone and what actually happens when we bill are two different things.
When you’re searching “Aetna chiropractor near me” location really does matter. Not just because you don’t want to drive across town for treatment but because chiropractors contract with insurance differently in different areas.
Our Glendale office is right off Cherry Creek and super easy to get to from University Hills, downtown Denver, or anywhere in the southeast metro. We’re at 425 S. Cherry St., Suite 307. Easy parking. Quick access from I-25.
But more importantly we’re in-network with most Aetna plans in the Denver area. That means lower out-of-pocket costs for you. When you go to an in-network chiropractor your Aetna benefits work better and you usually pay less.
I’ve had patients drive from Aurora or Lakewood because they wanted a chiropractor who actually knows how to work with Aetna. Who can verify benefits when you come in. Who won’t surprise you with a huge bill after treatment.
Most Aetna plans cover chiropractic adjustments for treating things like:
What they usually don’t cover? Maintenance care or wellness visits once you’re feeling better. That’s the frustrating part. Insurance wants to pay for treatment when you’re hurt but not prevention to keep you from getting hurt again.
Some Aetna plans cover additional services like:
But this varies a lot by plan. That’s why we verify your specific benefits before starting treatment.
Here’s how it works when you’re an Aetna patient at our clinic. First you call us at 720-889-1659 and tell us you have Aetna insurance. We’ll get your member ID number and date of birth.
Before your first appointment we start to verify your benefits. We call Aetna and find out exactly what’s covered, what your copay is, if you need a referral, all that stuff.
When you come in for your appointment we’ll make a copy of your Aetna card and any referral if you need one. Most of the time, we’ll know your payment responsibility before we render any medical care for you. Otherwise, Aetna has what’s called a maximum limiting charge. That’s fancy speak for, it will never exceed a certain amount for that visit. We do the exam and treatment. We bill Aetna directly. You just pay your copay or whatever your plan requires.
After Aetna processes the claim they send you an Explanation of Benefits (EOB) showing what they paid and what you owe if anything. Pretty straightforward.
The thing I like about working with Aetna is they usually pay claims pretty quickly. Within 5-6 weeks most of the time. Some insurance companies take months. It’s annoying for everyone.
Aetna PPO Plans – These are pretty flexible. You can usually see any chiropractor you want but you’ll pay less if you see an in-network provider like us. No referral needed most of the time. Just a copay per visit.
Aetna HMO Plans – These sometimes require a referral from your primary care doctor before you can see a chiropractor. More restrictive but usually lower copays.
Aetna Open Access Plans – Kind of a hybrid between PPO and HMO. Sometimes you need a referral, sometimes you don’t. Depends on the specific plan.
Aetna Medicare Advantage – If you’re on Medicare with an Aetna Advantage plan, chiropractic is usually covered but limited. Medicare traditionally only covers manual manipulation of the spine to correct subluxation. Not all the other stuff we do.
Aetna Medicaid – Some Aetna Medicaid plans cover chiropractic, some don’t. Colorado Medicaid is tricky with chiropractic coverage.
I know this is confusing. That’s why we handle the verification for you.
If you’re coming in as an Aetna patient here’s what you need:
We’ll take care of the rest. Fill out some paperwork about your health history and what’s bothering you. Do an exam to figure out what’s wrong. And start treatment if appropriate.
Most first visits take about 30 minutes. We’re not rushing you through.
Here’s the truth about insurance – it’s designed to be confusing. I’m convinced of this. They use terms like deductible, copay, coinsurance, out-of-pocket maximum. And half the time even the insurance reps don’t fully understand their own plans.
Deductible – That’s the amount you pay out of pocket before insurance starts covering anything. Some Aetna plans have deductibles, some don’t. If yours does you might have to pay full price for visits until you meet it.
Copay – That’s a flat fee you pay per visit. Like $20 or $30 or whatever your plan says. Usually due at time of service.
Coinsurance – That’s a percentage you pay after you meet your deductible. Like insurance pays 80% and you pay 20%.
Out-of-pocket maximum – Once you hit this amount in a year insurance often covers everything at 100%, but not always. But most people don’t hit this unless they have major medical stuff going on.
For chiropractic care most Aetna plans work on a copay basis. You pay your copay, Aetna covers the rest. Simple.
Look there are a lot of chiropractors in Denver who take Aetna insurance. So why come to us?
First we actually verify your benefits before you come in. A lot of offices don’t do this and then you get surprised with a bill later. We tell you upfront what things will cost.
Second we’ve been doing this for 14+ years. I know how to work with insurance companies. How to document properly so claims get paid. How to handle denials if they happen. You’re not dealing with someone who’s learning as they go.
Third we’re conveniently located in Glendale right off Cherry Creek. Easy to get to from pretty much anywhere in Denver. You’re not driving an hour each way for treatment.
Fourth we treat you like a person not an insurance number. Yeah we’ll bill your Aetna plan but our focus is on getting you better. Not on how many visits your insurance will cover or how much we can bill.
And to be totally transparent? We’re just good at what we do. We’ve helped thousands of Denver patients with back pain, neck pain, headaches, sciatica, sports injuries, all that stuff. The reviews speak for themselves.
Most people come in with back pain or neck pain. That’s bread and butter chiropractic stuff and Aetna covers it well.
But we also treat:
Basically if it’s a musculoskeletal problem – something wrong with your bones, joints, muscles, or nerves – we can probably help. And your Aetna insurance will usually cover at least some of it.
I’m gonna be real with you. Insurance coverage for chiropractic has gotten better over the years but it’s still not perfect.
Most Aetna plans limit you to 20-30 visits per year. Which sounds like a lot but if you have a serious injury it might not be enough. And once you hit that limit you’re paying out of pocket.
Some conditions take longer to heal than insurance wants to cover. Like if you’ve had chronic back pain for 10 years it’s probably not gonna be fixed in 12 visits. But that’s what insurance might cover.
And insurance rarely covers maintenance care or prevention. They want to pay when you’re hurt but not to keep you from getting hurt in the first place. It’s backwards but that’s how it works.
Here’s what we do – we work with what your Aetna plan covers. We maximize your benefits. And if you need more care than insurance will pay for we have affordable self-pay rates. Because the goal is getting you better not just using up your insurance benefits.
This comes up a lot. If you were in a car accident or got hurt at work do you use your Aetna health insurance or something else?
For auto accidents usually you’d use the auto insurance not your health insurance. Either your own auto policy (med pay or PIP coverage) or the other driver’s liability insurance if they were at fault. Aetna typically doesn’t want to be billed for auto accident injuries.
For work injuries you’d use workers comp not your Aetna plan. Workers comp covers all your medical treatment related to the work injury at no cost to you.
But sometimes it’s not clear cut. Like if you got rear-ended and you’re not sure about the insurance situation we can bill your Aetna plan while things get sorted out. Just know they might deny it later if they find out it was from an accident.
The important thing is to get treated. We can figure out the billing afterwards if needed.
Not all chiropractors who take Aetna are created equal. Here’s what to ask before making an appointment:
Are you in-network with Aetna? – This matters for your costs. In-network means lower copays and better coverage.
Do you verify benefits before treatment? – You want to know what you’ll owe upfront not after treatment starts.
How do you handle billing? – Do they bill Aetna directly or do you have to pay and get reimbursed? Direct billing is way easier.
What’s your experience with Aetna patients? – Someone who works with Aetna regularly will navigate the system better than someone who rarely does.
What if my benefits run out? – What are the self-pay rates if you need more treatment than insurance covers?
Do you do the paperwork or do I? – Trust me you want the office to handle the insurance paperwork not you.
We answer yes to all the right questions. We’re in-network with most Aetna plans. We verify benefits before you come in. We bill Aetna directly. We’ve worked with thousands of Aetna patients. We have fair self-pay rates. And we handle all the insurance hassle for you.
If you’ve got Aetna insurance and you’re dealing with back pain, neck pain, headaches, sciatica, or any other musculoskeletal problem here’s what to do.
Call us at 720-889-1659. Tell us you have Aetna and want to schedule an appointment. We’ll get your insurance info and verify your benefits before you come in.
We’re located at 425 S. Cherry St., Suite 307 in Glendale. Easy to find, easy parking, easy access from anywhere in the Denver metro area.
We’ll figure out exactly what your Aetna plan covers, what your copay is, if you need a referral, all that stuff. Then we’ll get you scheduled and start working on getting you out of pain.
Don’t let insurance confusion keep you from getting the care you need. We deal with Aetna every single day and we know how to make it work for you. Let’s get you feeling better.
Phone
720-889-1659
Email
support@myglendalechiro.com
Hours
Mon 9 AM – 12:30 P, 2:30 P – 6:00 P
Tue 9 AM – 12:30 P, 2:30 P – 6:00 P
Wed 9 AM – 12:30 P, 2:30 P – 6:00 P
Thu 9 AM – 12:30 P, 2:30 P – 6:00 P
Fri – Closed
Sat – Closed
Sun – Closed
C O N T A C T
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