Doctor Finder and Know Your Health Plan

image1

Find a Doctor and/or Hospital

We've assembled a centralize location of Houston/Texas area health plan network provider finder links. Clicking on the network link below will take you to the provider search engine.

 

We always encourage you to contact your provider directly to see which networks they participate in and/or if they intend to participate in any network.

 

• Aetna - EPO Network

• Aetna - Memorial Hermann Network

• Blue Cross Blue Shield - Blue Choice & Blue Advantage Networks

• Cigna - HMO and PPO Networks

• Community Health Choice - Community Health Choice Network & KelseyCare Network

• Humana - HMO and PPO Networks

• Scott White Health Plans - HMO Network

• Memorial Hermann - Select PPO and HMO Network

• United HealthCare - HMO and PPO Networks

 

Participating insurance companies in the HealthCare.gov Marketplace (ObamaCare) plan network provider search links:


Know Your Health Plan

Know Your Health Plan (HMO vs PPO)

Health plans like HMOs and PPOs use certain groups of doctors, hospitals and other health care professionals who provide a full range of covered health care services. These are called provider networks. When looking for a provider, it's important to know about your network and the choices you have.

 

Which Health Plan or Network Do You Have?

Your health plan or network is shown on the front of your health plan member ID card. If you have questions about which network you have, call the Customer Service number on your card.

 

Tips for HMO Health Plan Members

Always go to your Primary Care Physician (PCP) first. When you apply for health insurance, you will choose or will be assigned a PCP. Your PCP is often a partner in keeping you healthy. A pediatrician can serve as your child’s PCP. An OB/Gyn can serve as a female member’s PCP.

 

Stay in-network. If you visit a doctor or a hospital that is not in your network, you will be responsible for the full cost of your care, in most cases. Use your plan Provider Finder to find doctors, specialists and hospitals in your network.

 

Get a referral for a specialist. If you need to see a doctor for a specific condition, your PCP will refer you to a specialist. Check your plan Provider Finder to make sure the specialist is in your network. You do not need a referral from your PCP to see your in-network OB/Gyn.

 

Use the ER for emergencies only. If your illness or injury is serious or life-threatening, call 911 or go to the nearest emergency room. You don't have to stay in-network.

 

Know where to go. Before you go for care, make sure you know how your plan works, what’s covered and where to go. It may save you time and money.

 

Tips for PPO Health Plan Members

Stay in-network. If you visit a doctor or a hospital that is not in your network, you will be responsible for the full cost of your care, in most cases. Use your plan Provider Finder to find doctors, specialists and hospitals in your network.

 

Find a doctor. You don't need a referral to see a doctor or other health care professional for a specific health issue, but whoever you choose must be in your plan's network to avoid paying higher out-of-network costs. Check your plan Provider Finder to find an in-network specialists.

 

Get pre-authorization. Certain tests and procedures must be pre-approved before you go as described in your benefit documents. You or your doctor must call the pre-authorization (pre-certification) number on the back of your member ID card.

 

Use the ER for emergencies only. If your illness or injury is serious, call 911 or go to the nearest emergency room. You don't have to stay in-network.

 

Know where to go. Before you go for care, make sure you know how your plan works, what’s covered and where to go. It may save you time and money.