If you’re a member of the International Longshore and Warehouse Union (ILWU) and covered under the ILWU-PMA health plan, you have access to one of the most generous chiropractic benefit packages available. But even with strong coverage, many patients in Walnut Creek don’t know how to fully take advantage of it.
At Elite Chiropractic Rehab and Wellness, we’ve worked with numerous ILWU members and their families to help them receive effective, in-network chiropractic care—without billing confusion or delays. This guide breaks down exactly what ILWU covers, how it works, and what you need to know before scheduling your visit.
Understanding the ILWU-PMA Health Plan
The ILWU-PMA Coastwise Indemnity Plan provides comprehensive medical and chiropractic benefits to eligible longshore workers and their dependents. The plan is known for its generous chiropractic allowances—but it also has specific network rules, documentation requirements, and limits that must be followed to ensure full coverage. There are two primary types of ILWU health plans relevant to chiropractic patients:
- PPO (Preferred Provider Organization) Members
- HMO (Health Maintenance Organization) Members (typically through Kaiser)
Each type has different guidelines when it comes to visit limits, provider eligibility, and claims processing.
Chiropractic Coverage for PPO Members
If you’re an ILWU member with PPO coverage, your plan includes the following chiropractic benefits:
Covered Visits
ILWU PPO plans offer generous chiropractic coverage. Here are the visits covered throughout the benefit year, with more allowed early in care and additional visits available if medically necessary.
- Up to 40 chiropractic visits per benefit year (July 1 – June 30)
- Visit frequency often follows this schedule:
- Up to 12 visits in the first month of care
- Up to 10 visits in the second month
- Up to 8 visits in the third month
- Up to 5 visits in the fourth month
- Up to 5 visits in the fifth month
- Additional visits can be approved if deemed medically necessary
Cost to You
ILWU coverage makes in-network care simple and affordable. Here’s what you can expect to pay based on your provider’s network status.
- If you see a chiropractor within the CHPC (Chiropractic Health Plan of California) network, ILWU covers 100% of the PPO rate—meaning you have no out-of-pocket cost.
- If you visit a chiropractor outside the network, the plan only covers 80% of the allowable rate, and you’re responsible for the remaining balance.
Elite CRW is part of the CHPC network, so your visits with us are typically fully covered under the PPO plan.
Imaging & Diagnostics
Chiropractic X-rays and diagnostic imaging are covered up to $100 per year, reimbursed at 100%.
Visit Review Process
ILWU tracks visit usage to ensure effective treatment. Here’s what happens if your care goes beyond the standard limits.
- If your care exceeds the plan’s standard frequency or visit caps, your file may be referred for review by a chiropractic consultant.
- Approval for continued care depends on demonstrating ongoing clinical improvement and medical necessity.
Chiropractic Coverage for HMO Members
ILWU members enrolled in an HMO plan—most commonly through Kaiser Permanente—have slightly different rules.
- Chiropractic services must be accessed through your HMO network or an approved referral system.
- You may be required to get authorization before receiving care outside of your primary care provider’s network.
- Elite CRW is not currently in-network with HMO plans like Kaiser, so you may need to confirm referral eligibility or consider PPO enrollment for broader chiropractic access.
What ILWU Chiropractic Coverage Typically Includes
Whether you’re a PPO or HMO member, ILWU’s plan is designed to support care for acute and chronic musculoskeletal conditions, including:
- Back pain and disc issues
- Neck tension or stiffness
- Sciatica and pinched nerves
- Joint pain and inflammation
- Muscle tightness or spasms
- Recovery after lifting injuries or repetitive motion strain
Covered services may include:
- Spinal adjustments and manipulations
- Physical rehabilitation and corrective exercises
- Myofascial release and soft tissue therapy
- Re-evaluations to assess treatment progress
- X-rays, when clinically indicated
At Elite CRW, we provide all of these services in-house and ensure that all treatments are billed according to ILWU plan requirements.
Coordination with Medicare (for Eligible Members)
If you’re a retired ILWU member or qualify for Medicare, ILWU becomes your secondary insurance.
- ILWU coverage will coordinate benefits with Medicare and reduce your out-of-pocket costs for eligible services.
- You must submit a copy of your Medicare Explanation of Benefits (EOB) when submitting chiropractic claims through ILWU.
- Elite CRW will help you navigate this process and submit documentation appropriately.
How Elite CRW Supports ILWU Members in Walnut Creek
Our clinic understands the ILWU plan inside and out. We’ve helped union members and their dependents:
- Verify chiropractic benefits before care begins
- Ensure treatment plans align with the 40-visit limit and medical necessity requirements
- Avoid denied claims through correct coding and documentation
- Request authorization for continued care, when needed
- Track and report progress as required by ILWU chiropractic consultants
Our front desk team handles insurance paperwork and makes the process simple—so you can focus on your recovery.
Tips for Maximizing Your ILWU Chiropractic Benefits
To get the most out of your coverage, follow these guidelines:
- Choose an in-network CHPC provider like Elite CRW to avoid balance billing
- Stay within your visit schedule, or make sure your chiropractor submits proper documentation for continued care
- Track your visit count—especially as you approach the 40-visit annual limit
- If you’re a retiree, coordinate benefits with Medicare to avoid delays
- Ask questions—we’re here to help you understand your plan and how it works
Final Thoughts
ILWU members are fortunate to have access to one of the most comprehensive chiropractic benefit structures in California—but those benefits are only valuable if you know how to use them.
At Elite Chiropractic Rehab and Wellness in Walnut Creek, we’re proud to serve the ILWU community with expert care, full insurance support, and treatment that gets results. Whether you’re recovering from an on-the-job injury or managing chronic pain, our team is here to make sure your coverage works for you.
Schedule your visit today or call us to confirm your ILWU chiropractic eligibility and start your care with zero hassle.
