Dear Questions and Benefits,
I want to see a chiropractor, but it's expensive. Does Tricare cover chiropractic care for families?
I heard they have chiropractors at military hospitals, but families can't use them. Why not?
-- Army spouse Anne
It's pretty simple: Tricare does not cover chiropractic care for families.
That does seem arbitrary -- and unfair. If you're a family member who wants or needs to see a chiropractor, you're basically out of luck unless you're willing to pay out of pocket.
First, let's talk about Tricare's coverage rule. According to its website, it simply doesn't cover the service for family members, retirees or Tricare Reserve Select users. Instead, that care is available only for active-duty troops or for activated Guard or Reserve members.
It comes down to two things: Congress and money.
Here's a little background. Back in 1993, military health care officials realized they had limited money and many health care problems -- and that spending cash on chiropractic benefits wasn't a priority.
Still, in 2000, Congress ordered Tricare to start providing chiropractic care for active-duty troops, but only at military hospitals. The goal, the legislation says, is to treat "at a minimum, care for neuro-musculoskeletal conditions typical among military personnel on active duty."
In other words, Congress knew troops have a lot of problems that come from activities like hauling around huge amounts of weight and jumping out of airplanes. Chiropractors, they decided, can help.
But the legislation is very specific: Tricare must provide the service only to troops at military hospitals, and not even all of them. If a chiropractor isn't available, troops cannot get a referral off base.
In 2013, the Government Accountability Office found there were a mere 90 chiropractors at 62 military treatment facilities serving the entire active-duty force.
Meanwhile, the law governing what Tricare can and cannot cover for non-active duty users explicitly forbids it from covering chiropractic care for dependents. For Tricare to be able to cover chiropractic care, that language must be changed.
That means Congress has to not only act, but must agree that spending money on an entirely new service is a good idea. That seems unlikely.
Nonetheless, every year or so, legislation is offered to try to add the benefit and then dies without gaining any traction.
In an era of skyrocketing costs for the health care it's already authorized or ordered to provide, it's unlikely the Pentagon will lobby to add this expensive new service.
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