2024 Evidence of Coverage for UnitedHealthcare® Group Medicare Advantage PEBB Complete (PPO) Chapter 4: Medical Benefits Chart (what is covered and what you pay) 82 Services that are covered for you What you must pay when you get these services in-network and out-of-network uses hands-on pressure to gently move your joints and tissues. Excluded from Medicare coverage is any service other than manual manipulation for the treatment of subluxation, including: · Maintenance therapy. Chiropractic treatment is considered maintenance therapy when continuous ongoing care is no longer expected to provide clinical improvements and the treatment becomes supportive instead of corrective. · Extra charges when your chiropractor uses a manual, hand-held device to add controlled pressure during treatment. · X-rays, massage therapy, and acupuncture (unless the acupuncture is for the treatment of chronic low back pain). Routine chiropractic services‡ $0 copayment for each visit* Includes 24 visits per plan year. Please turn to Section 4 Routine chiropractic services of this chapter for more detailed information about this chiropractic benefit. There is no coinsurance, Colorectal cancer screening copayment, or deductible for a The following screening tests are covered: Medicare-covered colorectal · Colonoscopy has no minimum or maximum age cancer screening exam, limitation and is covered once every 120 months (10 excluding barium enemas, and years) for patients not at high risk, or 48 months after a colonoscopy. previous flexible sigmoidoscopy for patients who are There is no coinsurance, not at high risk for colorectal cancer, and once every 24 copayment, or deductible for