Delaware is expanding mandatory health insurance coverage for chiropractic and physical therapy services as part of efforts to reduce opioid dependence among chronic pain patients.
Currently, Delaware law requires all health insurance plans in the state — including individual policies, group coverage, state employee benefits, and Medicaid — to provide unlimited chiropractic and physical therapy visits for chronic back pain treatment. However, this coverage has been limited to specific areas of the spine.
A recent evaluation by the Patient Centered Care Subcommittee, part of the Addiction Action Committee within Delaware’s Department of Health and Social Services, revealed important gaps in the current system. The subcommittee surveyed Delaware-based chiropractic and physical therapy practitioners to assess how well the existing coverage requirements were working.
While the survey results indicated that unlimited coverage has enhanced care for chronic pain sufferers, researchers discovered the benefits were restricted to only two spinal regions: the thoracic area (middle spine from neck base to rib bottom) and the lumbar region (lower back area).
Health officials noted that comprehensive chiropractic and physical therapy care can help patients avoid both opioid medications and costlier medical interventions. However, the current limitations on which body areas receive coverage may reduce treatment effectiveness and restrict patient recovery potential.
The new legislation addresses these concerns by expanding coverage requirements to include the entire spine plus other neuromusculoskeletal areas, including arms and legs, without annual or lifetime visit restrictions.
Insurance companies will need to comply with these enhanced coverage mandates for any policies that are issued, renewed, or modified after December 31, 2026.
The legislation also includes technical language updates to align with current Delaware legislative drafting standards.
