We are in-network with Blue Cross Blue Shield of Texas at all three of our Houston offices, including the PPO and HMO plans most Houston employers offer. In-network means your visits are billed at the contracted rate BCBS of Texas has already agreed to, not at whatever an out-of-network office decides to charge.
We also accept Anthem Blue Cross, which is a separate company under the same Blue Cross umbrella and causes more confusion than any other insurance question we hear. There is a section on that below.
What in-network status does not tell you is what your own plan pays. That comes down to your deductible, your copay, and whether your plan caps the number of visits. We check all of it before your first appointment and tell you what we find, in plain numbers, before you owe anything.
Does Blue Cross Blue Shield of Texas cover chiropractic care?
Most Blue Cross Blue Shield of Texas plans include chiropractic coverage. It is a standard benefit rather than an add-on, and the question is almost never whether your plan covers it at all. The question is what share of the visit lands on you, and that varies plan to plan even between two people who both work in the Medical Center and both hand us a BCBS of Texas card.
Four things decide it. Your deductible is what you pay across all your healthcare before the plan starts contributing, so if you have already had labs or an imaging study this year, part of it may be behind you. Your copay is the flat amount per visit, and it is usually printed on the card. Chiropractors are listed as specialists on most plans, so it is the specialist copay that applies, not the primary care one, which is the single most common surprise we correct at the front desk. And once your deductible is met, many plans pay a percentage rather than the whole thing.
Some plans also put conditions on the visits themselves. A plan might cover care that is treating an active problem and not cover visits once you are stable. That distinction matters more than the raw visit count, and it is worth knowing before you start rather than in month three.
Blue Cross Blue Shield of Texas is the card we see most often in our Houston offices, which is not surprising given how many energy companies and Medical Center employers buy their plans through it. That volume is the reason we can usually tell you within a day of your call what your plan looks like. It is also why we stopped guessing years ago. When you see enough BCBS of Texas cards, you learn that the logo tells you almost nothing and the plan documents tell you everything.
None of that is knowable from the outside. Two people with BCBS of Texas cards from the same employer can have different deductibles because they chose different tiers at open enrollment. So we verify your specific plan before your first visit and give you the actual numbers. If you would rather understand the mechanics first, we wrote a longer piece on what your insurance actually covers for chiropractic care.
What is the difference between a PPO and an HMO for chiropractic?
This is the question the plan card does not answer, and it changes what you have to do before you can be seen.
On a BCBS of Texas PPO, you can generally come straight in. No referral, no gatekeeper, and you can see an out-of-network provider if you want to, though you pay more for it. The tradeoff is that PPO premiums tend to run higher, which is why employers offer both.
On an HMO, the network rule is stricter and the referral question is live. Many BCBS of Texas HMO plans route specialist care through your primary care physician, and since chiropractors sit in the specialist category, that can mean a referral before your first visit is covered. Out-of-network care generally is not covered at all on an HMO, so being in-network is not a nice-to-have on those plans, it is the whole thing.
The practical version: if you are on an HMO, call us before you book and let us check whether your plan wants a referral first. It takes one phone call and it is a great deal easier than sorting it out after a visit has already happened. If you are on a PPO, you can book and we will verify in the background. Either way we tell you what we found before we start care.
What a referral actually involves is usually smaller than people expect. Your primary care physician documents the complaint and issues the referral, often without an office visit if you have been seen recently. The part that catches people is the timing: a referral dated after the visit does not always cover the visit. So the order matters, and that is the whole reason we ask about your plan type before you come in.
One thing we will not do is tell you which plan to pick at open enrollment. That depends on your whole family's healthcare, not on chiropractic.
Do you accept Anthem Blue Cross?
Yes. We take Anthem Blue Cross.
Here is why people ask. Blue Cross Blue Shield is not one company. It is a federation of independent companies that each run their own state or region, and Anthem operates the Blue Cross plans in a group of states that does not include Texas. So if you moved to Houston from California, Colorado, Georgia or New York and kept your plan through work, your card may say Anthem Blue Cross while everyone here talks about BCBS of Texas. Both are Blue Cross. They are not the same company, and the coverage on your card follows the plan you actually have, not the state you are standing in. Bring the card and we will verify it the same way we verify a Texas plan.
How many chiropractic visits does BCBS of Texas cover?
A cap on chiropractic visits per calendar year is common on BCBS of Texas plans, and it is one of the details people most often discover late. We are not going to print a number here, because the number is written into your specific plan and quoting someone else's would be worse than saying nothing.
What we can tell you is how to find yours. It appears in your plan documents under the chiropractic or specialist benefit, and BCBS of Texas member services will read it to you off the phone. We also pull it as part of the benefit check, along with whether the count resets in January or on your plan year, which are not always the same date. If your plan has a tight cap, that changes how we schedule you. We would rather build a plan around the visits you actually have than run you out of coverage halfway through.
The reset date is worth a second look if you are starting care late in the year. Someone who begins in November on a January-reset plan gets two allotments across a stretch of eight weeks, and someone who begins in November on a July-reset plan does not. That is not a reason to rush a decision about your spine. It is a reason to ask the question before you plan out the next few months.
How do you find out what your plan covers before your first visit?
We do it for you. Give us the name on the plan, the member ID off your card, and your date of birth, and we contact Blue Cross Blue Shield of Texas directly and pull your benefits.
You get back the real numbers: deductible and how much of it is already met, your specialist copay, any coinsurance percentage, the visit cap if your plan has one, and whether a referral is required. We go through it with you before care starts, so nothing about the money is a surprise later.
You can also call the number on the back of your card and ask the same questions yourself. Some people prefer to. Either way, the answer should exist in writing before your first adjustment, not after it.
Looking for a chiropractor near you that takes Blue Cross Blue Shield?
We have three Houston offices, and all of them take Blue Cross Blue Shield of Texas.
Greenway Plaza — 3334 Richmond Avenue #107, Houston, TX 77098 · (713) 929-4330
Galleria — 1770 Saint James Place #210, Houston, TX 77056 · (713) 622-3300
Memorial City — 10497 Town & Country Way #100, Houston, TX 77024 · (713) 770-6990
Most of our BCBS patients find us because they searched for a chiropractor near them who takes their plan, then ran into the thing nobody explains well. Taking your card and being in-network are two different things. A clinic can happily run your Blue Cross card and still bill you at out-of-network rates, which is how people end up with a bill three months later that they never saw coming.
We're in-network, so your visits process at your plan's in-network rate. If you work in Greenway Plaza or the Galleria, you can usually get in and out on a lunch break. Memorial City runs the same way for the Energy Corridor commute.
One thing worth knowing before you book. Your adjustment and your x-rays typically run through your BCBS benefit. Some of what we do sits outside standard insurance coverage, spinal decompression, PEMF, and HEIT are not covered services. We'll tell you which services are covered when we verify your benefits, before you're on the table, not after.
Frequently Asked Questions
Do you need a referral for chiropractic with BCBS of Texas?
On most BCBS of Texas PPO plans, no. You can book directly. On HMO plans a referral from your primary care physician is usually required, because chiropractors are categorized as specialists. We check your plan's referral requirement as part of the benefit verification, before your first visit. You can also find this information on the BCBS website.
Is chiropractic covered under a BCBS PPO plan?
Chiropractic is a standard benefit on most Blue Cross Blue Shield PPO plans. What varies is your share: the deductible you have left, your specialist copay, and any coinsurance percentage after the deductible is met. Your plan documents carry the specifics, and we verify them before you are seen. There's usually a visit number - anywhere from 12-24 visits per year for most patients.
What is the copay for a chiropractor with Blue Cross Blue Shield?
It is the specialist copay on your plan, not the primary care copay, because chiropractors are listed as specialists on most Blue Cross plans. The amount is usually printed on your card. so check there first. If it is not, we get it from BCBS during the benefit check.
Does BCBS of Texas cover x-rays at a chiropractor?
Diagnostic imaging is covered on most plans when it is medically indicated, and it is generally handled under your imaging benefit rather than the chiropractic visit benefit. We take x-rays in our Houston offices when the examination calls for them, and we verify the imaging benefit alongside everything else.
Which Houston chiropractors take Blue Cross Blue Shield?
More than you'd think, because chiropractic is a standard benefit on most BCBS of Texas plans. The part that catches people out is in-network status. A clinic can take your Blue Cross card and still bill you as out-of-network, which costs you real money. CORE Chiropractic is in-network with BCBS of Texas at all three of our Houston offices. Call us with your member ID and we'll tell you what your plan actually pays before you book anything.
Worth knowing what those covered visits are buying. A first visit here is a conversation, an examination, and x-rays when the examination indicates them. We measure off those x-rays rather than looking at them once, and those measurements guide the adjustments on every visit after. Most people are not adjusted on day one at all, because we do not work on a spine we have not looked at.
Bring your Blue Cross card to your first visit, or send us the member ID ahead of time and we will have the benefit check done before you arrive. We see BCBS of Texas and Anthem patients at all three CORE Chiropractic locations in Houston: Galleria, Greenway Plaza, and Memorial City.