If you’re covered under the ILWU-PMA Coastwise Indemnity Plan, you have some of the most generous chiropractic benefits available—but you might not know exactly how to use them. Between provider networks, visit limits, and required documentation, it can feel like a lot to figure out.
At Elite Chiropractic Rehab and Wellness in Walnut Creek, we help longshore workers and ILWU-covered family members navigate chiropractic benefits every day. This guide will walk you through how to use your ILWU insurance step by step—without the guesswork.
Step 1: Know What Your ILWU Plan Covers
Most ILWU members are enrolled in the Coastwise Indemnity PPO plan, which includes extensive chiropractic benefits.
Here’s what’s typically covered:
- Up to 40 chiropractic visits per year (July 1 – June 30)
- 100% coverage when you see an in-network CHPC (Chiropractic Health Plan of California) provider
- Up to $100 per year for X-rays or diagnostic imaging
- Additional visits beyond the 40 may be approved with proper documentation
If you’re not sure which plan you’re on—PPO or HMO—we’ll help you verify that before your first visit.
Step 2: Choose an In-Network CHPC Provider
To receive full coverage with no out-of-pocket cost, you must see a chiropractor who participates in the CHPC network. ILWU only covers 100% of charges when you stay in-network.
Out-of-network care is only reimbursed at 80% of the “reasonable charge,” meaning you may be stuck paying the difference.
Elite CRW is a CHPC-participating provider, which means:
- Your chiropractic visits are billed directly to ILWU
- There are no copays or hidden fees for covered services
- We handle the claims and documentation for you
Step 3: Understand How the Visit Limit Works
Your plan allows up to 40 visits per benefit year, but it also follows a frequency schedule. That looks something like this:
- Month 1: Up to 12 visits
- Month 2: Up to 10 visits
- Month 3: Up to 8 visits
- Month 4 & 5: 5 visits per month
If your condition requires more care, we can request additional visits by submitting clinical documentation to the ILWU chiropractic consultant. We’ve done this many times and know exactly how to position your case for approval.
Step 4: Know What’s Considered Medically Necessary
ILWU covers care that is deemed medically necessary. That means you need a diagnosable condition with measurable improvement through treatment.
Examples include:
- Acute or chronic back pain
- Neck stiffness or misalignment
- Sciatica or nerve compression
- Joint dysfunction due to repetitive work
- Injuries from lifting, twisting, or falls on the job
At Elite CRW, we document your symptoms, progress, and outcomes carefully to ensure all treatments fall within the plan’s approved guidelines.
Step 5: If You’re on Medicare Too—Coordinate Benefits
If you’re retired or otherwise eligible for Medicare, ILWU acts as your secondary insurance. That means Medicare pays first, and ILWU may cover the balance.
To process a chiropractic claim under both:
- Medicare pays their portion (usually 80% of the approved amount)
- You provide the Explanation of Benefits (EOB) from Medicare
- ILWU reimburses you or your provider for the remaining 20%
We’ll walk you through this process and help with documentation so nothing falls through the cracks.
Step 6: Book Your Appointment and Let Us Handle the Rest
The last step? Let us take over. When you come to Elite Chiropractic Rehab and Wellness, we handle:
- Verifying your ILWU and/or Medicare benefits
- Tracking your visit usage
- Submitting claims correctly and on time
- Requesting additional visits if necessary
- Explaining any non-covered services before treatment
Our goal is to make sure you get the care you need—with no financial surprises or administrative stress.
Final Thoughts
Using ILWU insurance for chiropractic doesn’t have to be complicated. With the right provider, it’s as simple as showing up and focusing on your recovery.
At Elite CRW, we’re proud to be a trusted CHPC provider serving ILWU workers and their families in Walnut Creek. Whether you’re dealing with an injury, chronic pain, or preventive care needs, we’ll make sure your insurance works for you—not the other way around.
Book your visit today or call us to confirm your eligibility and get started.
