Managed Care Organizations
Please Note: This is a general overview and may be subject to change.
Managed Care Organization | Commercial HMO | Exchange | Work Comp | Medicare | Medicaid | Notes |
Aetna Healthcare | HMO, PPO, EPO, THR EPO | *Narrow Network selected by network cannot opt in | MA-HMO, MA-PPO, Prime MA | CHIP, KIDS, STAR | Must select one service area – DFW, Houston, or Austin | |
American Health Plan of TX | I-SNP | |||||
AmeriGroup![]() |
MA-HMO, MA-SNP | CHIP, DUAL, KIDS, STAR, STAR+PLUS | ||||
BlueCross & BlueShield of Texas![]() |
HMO, HME, PPO, POS, Premier | BAV | MA-PPO, MA-HMO | CHIP, KIDS, STAR, STAR PLUS | Administers TriWest and network is closed unless you have an active patient | |
Care N Care![]() |
MA-HMO MA-PPO | |||||
CareWorks | NWI, WC | |||||
ChoiceCare – Humana | PPO | MA-HMO MA-PFFS MA-PPO | ||||
CIGNA HealthCare of Texas![]() |
HMO, POS, OAP, PPO, Choice Fund | IFP Connect Exchange | MA-HMO MA-PPO | STAR PLUS | LocalPlus Narrow Network closed to new Tax IDs | |
Cook Children’s Health Plan | CHIP, KIDS, STAR | |||||
CorVel Healthcare, Inc. | AUTO, NWI, WC | |||||
First Health | PPO | |||||
EVRY | PPO | |||||
Galaxy Health Network | MSC, PPO, | NWI | ||||
GlobalHealth Texas Lonestar |
HMO, HMO C-SNP, HMO D-SNP, HMO-POS | |||||
HealthCare Highways | PPO | |||||
HealthSmart Preferred Care, Inc. | ACCEL, GEPO, HP, PPO | WC | ||||
Imagine Health | EPN PPO | |||||
Imperial Insurance Co, of TX | MA | |||||
Independent Medical Systems | PPO | |||||
LoneStar Athletic Injury Network | PPO | |||||
Molina Healthcare of Texas![]() |
EXCHANGE | MA | CHIP, DUAL, STAR, STAR PLUS | |||
MultiPlan | PPO | Med Adv Wrap Supplemental | ||||
National Preferred Provider Network (NPPN) | PPO | |||||
Nexcaliber | PPO | |||||
Oscar Insurance Co. of TX | EPO | |||||
PHCS (MultiPlan) | PPO | |||||
Prime Health Services, Inc. | GH | AUTO, IME, WC | ||||
Procura/Optum | Federal WC, WC, AUTO | |||||
Provider Select | PPO | |||||
Provider Partners Health Plan | I-SNP | |||||
Scott & White HealthPlan![]() |
HMO, PPO | MA-HMO MA-PPO | No Exchange Plan, No Baylor Quality Alliance Plans | |||
Superior HealthPlan | AMBETTER, VALUE | CHIP, DUAL, FC STAR, STAR PLUS | ||||
The Reny Company | WC | |||||
Three Rivers Provider Network | PPO | WC | ||||
TRICARE (Humana Military Healthcare Services) | Prime, 4Life | |||||
United Healthcare![]() |
HMO, EPO, OA, POS, PPO | MA HMO MA PPO MA SNP | CHIP, DUAL, SNP, KIDS, STAR, STAR PLUS | *NOTE: Contracting is completed directly – we handle the credentialing only. Visit UHCprovider.com for more details | ||
USA Managed Care Organization | PPO | WC | ||||
WellCare of Texas, Inc. | MA-HMO | Includes Texan Plus and Allwell |
Legend | |
CHIP = Children’s Health Insurance Plan DUAL = Star Plus (Medicare/Medicare) EPO/EPN = Exclusive Provider Organization FC = Foster Care Medicaid Program GEPO = Gatekeeper Exclusive Provider Organization GH = Group Health HMO = Health Maintenance Organization HPO = Health Payors KIDS = Star Kids Product |
MA = Medicare Advantage MSC = Medical Savings Card (Discount Card) NWI = Nonsubscriber Work Injury POS = Point of Service Plan PPO = Preferred Provider Organization OA = Open Access Plan SNP = Special Needs Program WC = Workers Comp |