TEXAS EXCHANGE

The Texas Insurance Exchange (Marketplace) is the Federally-Facilitated Marketplace.
The Federally-facilitated Marketplace is administered by the federal government, under the Department of Health and Human Services (HHS).

General information about the Federally-facilitated Marketplace can be found at: https://www.healthcare.gov/marketplace/individual/#state=texas.

PATIENTS

The Federally-facilitated Marketplace is essentially a marketplace for individuals to shop for health insurance if they do not already have insurance coverage from another source. If individuals have insurance from another source such as employment, retirement benefits, or spousal benefits, they do not need to obtain it from the Marketplace.

HIV PROVIDERS

Providers must contract with each of the Qualified Health Plans offered in the marketplace individually to participate fully in the Federally-facilitated Marketplace.

This process is similar to enrolling in insurance or managed care organization provider networks. See below the list of insurers participating in the Federally-facilitated Marketplace, and information about contacting them.

As an HIV provider, you may qualify for designation as an “Essential Community Provider (ECP).” The Qualified Health Plans participating in the Insurance Exchange (Marketplace) are required to contract with a minimum number of ECPs and Specialists to ensure network adequacy.

Visit our Provider Resources Section for more specific instructions to assist you in contacting health plans.

REPORTING PROBLEMS

QUALIFIED HEALH PLANS PARTICIPATING IN THE EXCHANGE

Below is a list of the Qualified Health Plans that have publically announced that they will offer plans in the Federally-facilitated Marketplace.
Wyoming has established Blue Cross Blue Shield of WY as the “benchmark” plan.
This list is being routinely updated, and may change as insurers join or drop out of the exchange. Please check back for updates.

Aetna
Plan Website: http://www.aetna.com/individuals-families/health-insurance-exchange.html
Provider Enrollment: http://www.aetna.com/healthcare-professionals/join-aetna-network/join-provider-network.html
Plan types offered: Individual

Ambetter from Superior Health Plan
Plan Website: http://www.superiorhealthplan.com/
Provider Enrollment: http://www.superiorhealthplan.com/for-providers/provider-network/
Plan types offered: Individual

Assurant Health
Plan Website: http://www.assuranthealth.com/corp/ah/AHHome.htm
Provider Enrollment: http://www.assuranthealth.com/corp/ah/Providers/health-care-provider.htm
Plan types offered: Individual

Blue Cross and Blue Shield of Texas
Plan Website: http://www.bcbstx.com/
Provider Enrollment: http://www.bcbstx.com/provider/network/index.html
Plan types offered: Individual

Blue Cross Blue Shield of Texas
Plan Website: http://www.bcbstx.com/
Provider Enrollment: http://www.bcbstx.com/provider/network/index.html
Plan types offered: Individual, SHOP

Cigna Health and Life Insurance Company
Plan Website: http://www.cigna.com/individuals-families/texas
Provider Enrollment: http://www.cigna.com/healthcare-professionals/join-our-network
Plan types offered: Individual

Cigna Healthcare
Plan Website: http://www.cigna.com/individuals-families/?WT.z_nav=IFP-State%20Medical%20Selector%3BHeader%3BIndividual%20%26%20Family%20Plans
Provider Enrollment: http://www.cigna.com/healthcare-professionals/?WT.z_nav=about-cigna%3BTop-Nav%3Bhealth-care-professionals
Plan types offered: Individual

Community Health Choice
Plan Website: https://www.chchealth.org/AffordableHealth/
Provider Enrollment: https://www.chchealth.org/ProviderPortal/Providers/Join_Network.aspx
Plan types offered: Individual

CommunityFirst
Plan Website: http://www.cfhp.com/
http://www.cfhp.com/Providers/WhatsNew/wanttojoin.asp
Plan types offered: Individual

Firstcare Health Plans
Plan Website: http://www.firstcare.com/marketplace
Provider Enrollment: https://my.firstcare.com/Portal/ProviderWelcome.aspx
Plan types offered: Individual, SHOP

Humana Health Plan of Texas, Inc.
Plan Website: https://www.humana.com/individual-and-family/products-and-services/medical-plans/
Provider Enrollment: https://www.humana.com/provider/medical-providers/network/
Plan types offered: Individual

Humana Insurance Company
Plan Website: https://www.humana.com/individual-and-family/products-and-services/medical-plans/
Provider Enrollment: https://www.humana.com/provider/medical-providers/network/
Plan types offered: Individual

IdealCare
Plan Website: http://www.senderohealth.com/en/idealcare/
Provider Enrollment: http://www.senderohealth.com/en/idealcarenetwork
Plan types offered: Individual

Molina Marketplace
Plan Website: http://www.molinahealthcare.com/members/tx/en-US/hp/marketplace/Pages/marketplace.aspx
Provider Enrollment: http://www.molinahealthcare.com/members/common/en-US/abtmolina/compinfo/Pages/contactus.aspx#
Plan types offered: Individual

Scott & White Health Plan
Plan Website: https://swhp.org/select-health-plan/individual-family-plans
Provider Enrollment: https://swhp.org/providers/join-swhp
Plan types offered: Individual

UnitedHealthcare
Plan Website: http://www.uhc.com/health_reform_guide.htm
Provider Enrollment: http://www.uhc.com/physicians/join_our_network.htm
Plan types offered: Individual

Valley Baptist Health Plan
Plan Website: http://www.valleybaptist.net/connect-with-us/our-health-plans
Provider Enrollment: http://www.valleybaptist.net/connect-with-us/our-health-plans
Plan types offered: Individual