Some KAC members have contacted us about a Humana Medicare Advantage notice their patients received regarding 2025 coverage changes. The notice, part of the Annual Notice of Changes, highlights updates to the plan but doesn’t reflect full coverage details. It states that chiropractic services will change from “$0 copay for routine chiropractic visits” to “not covered,” causing patient confusion.
Upon review, Humana Medicare Advantage will continue covering Medicare-covered chiropractic services (98940-98942) in 2025. It should be noted that, “routine chiropractic care”, often referred to as “maintenance care” are used interchangeably and that “routine chiropractic care”, will no longer be included under this plan. Medicare covered chiropractic services will still be covered referred to as the adjustment (98940-98942). We encourage all doctors to review the specific plan details themselves or guide their patients to explore their coverage further if patients bring in documents like this.
Example of this specific plan:
Chiropractic Services Covered by Medicare In-Network:
Chiropractic Services:
Copayment for Medicare-covered Chiropractic Services $20
Prior Authorization Required for Chiropractic Services
Out-of-Network:
Medicare Covered Chiropractic Services:
Coinsurance for Medicare Covered Chiropractic Services 50%
Link to individual plan: https://retiree.alight.com/find-plans/HumanaChoice-H5216-229-PPO&H5216:229-0
Examples:
Link to individual plan: https://www.medicareadvantage.com/plans/humanachoice-h5216-317-ppo-h5216-317-000
