Deductible:

Depending on your insurance plan, your chiropractic or acupuncture visit may or may not be subject to a deductible. Deductibles can vary widely—ranging from a few hundred to several thousand dollars per year.

In some cases, even if your plan has a high deductible, your visits may be exempt from it, meaning you’ll only be responsible for a co-pay or co-insurance at the time of your appointment.

However, in other situations, your visits do count toward your deductible. This means you'll need to pay the full visit cost out of pocket until you’ve met that deductible amount. After that, your insurance kicks in, and you’ll only pay the co-pay or co-insurance.

Most insurance plans include an individual deductible, and some also have a family deductible if multiple people are on the same plan.

If your deductible is high and it’s unlikely you’ll meet it before the end of the year, ask about cash pay options—these can help make your care more accessible and affordable.

Co-pay or Co-insurance: 

Out of Pocket Maximum:

Your out-of-pocket maximum (OOP) is the most you’ll have to pay out of your own pocket for covered healthcare services in a plan year. Once you’ve reached this limit, your insurance will cover 100% of the costs for any additional approved services for the rest of the year.

This amount is usually on the higher side, but it can be reached through any combination of eligible medical expenses—like hospital visits, surgeries, or even childbirth.

For example, if you have a baby or undergo an expensive procedure during the year, it’s likely you’ll meet your OOP. After that, you won’t owe anything for approved medical care that’s in-network and covered by your plan.

In-Network vs. Out-of-Network:

When a provider is in-network with your insurance, it means they’ve agreed to accept your plan and follow the insurance company’s contracted rates. In most cases, this benefits you by keeping your out-of-pocket costs lower—often just a co-pay per visit.

If a provider is out-of-network, it typically means a separate (and often higher) deductible applies before your insurance will begin covering services. However, this isn’t always the case—some plans offer similar benefits for both in- and out-of-network care, including comparable co-pays and deductibles.

For example, although we are currently out-of-network with UnitedHealthcare, many Nike employees with this plan have excellent out-of-network benefits for chiropractic care—often just a $20 co-pay, no deductible, and no visit limits.

That’s why it’s always worth checking your specific insurance benefits before ruling out care from an out-of-network provider. You might be surprised by how affordable it still is!

First, let’s break down a few common insurance terms you’re likely to come across:

What You’re Responsible For After Your Deductible

the amount you’re responsible for paying out of pocket for healthcare services before your insurance coverage begins to pay.

the amount you’re responsible for paying out of pocket for healthcare services before your insurance coverage begins to pay.

Chiropractic Vs Physical Therapy Benefits: 

Insurance benefits for chiropractic and physical therapy can sometimes overlap, which makes things confusing.

If you’ve been Dr. Wysocki's patient before, you know she often combines chiropractic adjustments with exercises or soft tissue work to help you heal faster. When these manual therapy or rehab services are billed by a chiropractor, they’re sometimes covered under your chiropractic benefits—which means you only pay your usual chiropractic co-pay.

However, in some cases, your chiropractic benefits only cover the adjustment itself, while the other therapies Dr. Wysocki provides may fall under your physical therapy benefits. She always check your physical therapy coverage ahead of time to see if there’s a separate deductible or visit limits.

That said, insurance billing can be tricky—sometimes what the insurance company tells us about how services are billed doesn’t match how they actually process the claim. We do our best to be transparent about which benefits are being used, but it’s a good idea for you to double-check with your insurance company too, just to be safe.

What is PIP and what does it cover?

In Oregon, every auto insurance policy includes Personal Injury Protection (PIP). This coverage acts like a built-in health insurance plan tied to your vehicle. PIP pays for medical treatment caused by a collision—no matter who was at fault.

PIP also follows you personally. If you’re injured as a pedestrian or cyclist, your own auto insurance PIP will cover your treatment.

PIP pays up to two years of medical bills or $15,000 in treatment—whichever comes first—for each person involved in the crash.

We’re happy to verify your benefits as a courtesy, and we always encourage you to stay familiar with and keep track of your own coverage as well.

While we do our very best to provide accurate information, there are times when the person or online portal we verify with may give incorrect quotes. Even during verification, we are often reminded that the quoted amounts might not be final, and insurance companies cannot be held responsible for communication errors—meaning the responsibility ultimately falls on the patient.

If you ever receive a surprise charge, we’re always here to help investigate the billing and identify any errors. However, the most empowering thing you can do is to understand your benefits before your care begins.

Chiropractic Vs Physical Therapy Benefits: 

Putting it all together: