Insurance Made Simple: Your Coverage in Redmond WA

One of the most common questions we receive at Redmond Spine Center (formerly Redmond Roots Chiropractic) our Redmond WA chiropractic clinic is: "Do you accept my insurance?" The short answer is likely yes! We’re in-network with most major insurance providers, including Regence, Premera, Aetna, LifeWise, United Healthcare, and more. However, there are a few exceptions, such as Kaiser HMO (where they won’t let me in-network) and State Insurance (Which simply just doesn’t cover Chiropractic at all). But for the vast majority of our patients, your insurance is likely accepted.

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Insurance Basics: What You Need to Know

To help you better understand how your insurance works, let's break down the three main components:

1. Visit Limits
2. Coverage Amounts
3. Deductible (Important)

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Visit Limits In Redmond WA

Your insurance plan may specify a certain number of visits covered each year.

For Example: You might have 20 visits for chiropractic care and 60 visits for physical therapy.

These visit limits are dictated by your specific insurance plan, and is typically counted on a calendar-year basis, meaning you can use these benefits from January to December. Your visit limits counter will reset each January, typically.

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Coverage Amounts

Beyond visit limits, it's important to understand how much of each visit is covered. There are two primary ways insurance covers your visits:

1. Co-Pay: This is a fixed amount you pay for each visit, such as $20, $30, or $50, depending on your plan. It’s simple—no matter what services you receive during your visit, you pay the same co-pay amount.
2. Co-Insurance: This is a percentage-based amount of shared cost. For example, if your co-insurance is 20%, you would pay 20% of the cost of your visit, while your insurance covers the remaining 80%. The exact amount you pay can vary based on the services you receive.

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Deductibles and Co-Insurance: What You Need to Know

Understanding deductibles can be tricky. A deductible is the amount you must pay out of pocket before your insurance begins to share the costs. Once you meet your deductible, your insurance will start covering a portion of your care, often in the form of co-insurance.

For Example: If you have 20 chiropractic visits covered at 80%, but you have a deductible of $500, you’ll need to pay for your care 100%, until you have paid $500 in medical expenses. Once you have met your deductible, you would then only owe 20% if your visit and your insurance will cover 80%, for 20 visits. It’s very important to know that you must meet your deductible first before your insurance starts to cover a percentage of your visits.

The good news is your deductible is a blanket deductible for any and all care you might receive, whether it’s chiropractic or not.

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Transparency and Clarity: Our Commitment to You

We know that insurance can be complicated, but we're here to make it as straightforward as possible. This is why we ask you to send us your insurance information before your first visit, so we can verify what your benefits are, so we can go over them with you. Once we verify your benefits, we can let you know your exact benefits and whether you’re dealing with a fixed co-pay, a percentage-based co-insurance, or a deductible, and what we expect your exact costs to be with anything you do here in the office.

Our goal is transparency. We want you to fully understand your coverage, your responsibilities, and what to expect when you visit our office. By making sure we’re all on the same page, we can focus on what really matters—your health and well-being.

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Questions? We're Here to Help!

If you have any questions or concerns about your insurance coverage, or if you just want more clarity on how everything works, don't hesitate to reach out. We're more than happy to assist you in any way we can.

We look forward to seeing you at Redmond Roots Chiropractic!