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, ATC Inc.   PPO      
Care N Care       MA-HMO

MA-PPO

  
CareWorks – fka RockPort     NWI, WC    
Children’s Medical Center Health Plan – Star Kids         KIDS
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
EVRY   PPO      
Family Healthcare – fka Texas Bluebonnet HMO PPO, EPO   MA  
Galaxy Health Network MSC, PPO NWI
Global Health Medicare Advantage       MA  
HealthCare Highways   PPO   MA  
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      
QuikTrip Employer Benefit Plan   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