Managed Care Organizations

Please Note: This is a general overview and may be subject to change.

Managed Care Organizations

Managed Care Organization Commercial HMO Commercial PPO Work Comp Medicare Medicaid
Aetna Healthcare HMO PPO

THR EPO

MA-HMO MA-PPO CHIP, KIDS, STAR
AmeriGroup MA-HMO

MA-SNP

CHIP, DUAL, KIDS,  STAR, STAR PLUS
BlueCross & BlueShield of Texas HMO, HME BAV, PPO, POS MA-PPO CHIP, KIDS, STAR, STAR PLUS
Bright Health Management PPO EXCHANGE
Care N Care MA-HMO

MA-PPO

CareWorks – fka RockPort NWI, WC
ChoiceCare  – Humana PPO MA-HMO

MA-PFFS

MA-PPO

CIGNA HealthCare of Texas HMO, POS CHOICE FUND, OA PLUS, PPO, MA-HMO

MA-PPO

STAR PLUS
Cook Children’s Health Plan CHIP, KIDS, STAR
CorVel Healthcare, Inc. AUTO, NWI, WC
Coventry – First Health PPO AUTO, WC
Friday Health Plans PPO
Galaxy Health Network MSC, PPO NWI
HealthCare Highways PPO
HealthScope Benefits (DART) PPO
HealthSmart Preferred Care, Inc. ACCEL, GEPO, HP, PPO WC
Imagine Health EPN
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
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
Provider Select PPO
Scott & White HealthPlan HMO PPO MA-HMO MA-PPO
Stone Mountain Risk PPO
Superior HealthPlan AMBETTER MA-HMO CHIP, DUAL, FC STAR, STAR PLUS
TexanPlus MA-HMO
Texas Healthcare Foundation NWI, WC
The Reny Company WC
Three Rivers Provider Network PPO WC
TRICARE (Humana Military Healthcare Services) HMO PPO
United Healthcare HMO EPO, OA, POS, PPO MA HMO MA PPO

MA SNP

CHIP, DUAL, SNP, KIDS, STAR, STAR PLUS
USA Managed Care Organization PPO WC
WellCare of Texas, Inc. MA-HMO

 

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

HP = 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 or Network

SNP = Special Needs Program

WC = Workers Comp