MEDICARE---What is "Maintenance Care" and Why Won't Medicare Pay For It?

     Medicare guidelines state that they will only pay for chiropractic treatment that is Medically Reasonable or Necessary (defined as treatment that yields a significant improvement in clinical findings and patient functionality). 

     To you, and in the clinical judgement of your chiropractor, your treatment may be CLINICALLY APPROPRIATE:  it may enhance your life, relieve your symptoms, support your health and well-being, or prevent the deterioration of a chronic condition. 

     But treatment that is CLINICALLY APPROPRIATE may not fit Medicare’s definition of MEDICALLY NECESSARY. Your chiropractor, by law. must inform Medicare when your care is maintenance care, so that Medicare understands that this care is not reimbursable, and you will be responsible for payment.

Do You Need a Heel Lift?

Sometimes patients come to me who have been told by another caregiver that they need to wear a heel lift in one shoe. Careful assessment often shows that the patient does, in fact, have one leg shorter than the other, but the difference is not anatomical, but functional.

Anatomical leg length difference is when one leg is actually physically shorter. This may be due  to a previously healed fracture in the leg, or it may be congenital. Wearing a heel lift in this case can be the right thing to do. The lift should be prescribed and designed specifically for the patient by a qualified practitioner.

Functional leg length difference is due to distortions or imbalances in the person’s frame---the entirety of the bones and joints of their body. Once the distortions or imbalances have been corrected, which is exactly what I do, the legs will even. In this case, wearing a heel lift is a bad idea. It is only worsening the problem.

Numbness or Tingling in the Arm or Hand

      Nerve impingement of the brachial plexus, the nerves which exit the spine in the neck, can cause numbness or tingling in the arm and / or hand.

     If the alteration of sensation is diffuse throughout the upper extremity, all or most of the nerves in the brachial plexus may be affected, sometimes due to impingement between the clavicle and the first rib, or in passage between the scalene muscles at the sides of the neck. 

     However, if only parts of the arm or hand are affected, it may be possible to pinpoint the specific spinal nerves that are being impinged. This can guide the chiropractic adjustment which can help alleviate the problem.

Why NOT to Bake With Most Nut "Flours"

 It has become popular to bake cookies, cakes, etc. with almond “flour” or other nut “flours,” particularly in the Paleo community, which advocates avoiding grains. With the exception of coconut flour, which does not readily oxidize, using nut flours for baking is hazardous, because all nuts contain unsaturated oils. These oils readily oxidize at room temperature when nuts are ground into flour.

Oxidized oils (monounsaturated or polyunsaturated oils take on oxygen across their carbon-carbon double bonds) are highly inflammatory and very unhealthy.

When dough is made by grinding nuts into flour in a cookie, etc., recipe, and baking it, the heat of the oven accelerates oxidation of these oils.

What can you do if you don’t want to use grain flours for baking?

All nuts contain some combination of saturated, MONOunsaturated, and POLYunsaturated oils. Baking with coconut flour, which contains almost 100% saturated oil, is safest, because saturated oils will not oxidize. 

    

What's Medicare Done For You Lately?

If you have a question, you can call Medicare (1-800-MEDICARE), and you will reach an actual person, who will answer your questions with patience and courtesy.

Your annual deductible is just $166.00!

        When Medicare receives your Doctor's Statement for your chiropractic care, they process it first, then they automatically send it on to your supplemental insurance for that part of processing. You don't have to do a thing!  

Medicare covers chiropractic care, but currently, only for treatment to the spine. It doesn’t cover extremities, exams, or adjunct therapies. Yet. But we’re (your chiropractors) working on it.