Phantom Coverage and Other Insurance Regularities
Written by Chris G. Dalrymple D.C., F.I.C.C.   
Wednesday, May 09, 2018 03:40 PM

The Texas Chiropractic Association (TCA) is aware of phenomena that have been termed “phantom insurance coverage.”  There have been reported instances where an insurance company advertises a plan that seems to offer certain coverage, but then imposes restrictions to such a degree that the advertised coverage is nonexistent. 

A classic example of such “phantom coverage” is “chiropractic coverage” that is, for example, limited to $500 per year after a $500 co-pay.  This means that the patient will pay the first $500 after which there are no more payable benefits for chiropractic.  In this example the “chiropractic coverage” is considered phantom coverage in that the patient actually has no coverage for chiropractic services.  These and other examples have been reported by practitioners.  The TCA needs documented examples of such phantom coverage.  Please contact TCA to share any examples of such phantom coverage that you encounter in your practice.

If you encounter other unusual insurance irregularities resulting the in inequitable treatment of chiropractic patients and doctors please report them to the TCA so that we may ensure equitable public access to chiropractic health care.  

The TCA, the leading chiropractic professional association in Texas, seeks to enhance public access to chiropractic health care and to oppose practices oppressive to chiropractic patients and doctors.