Insurance and Billing Accepted Insurance Plans
If Texas Children's is an out-of-network provider, health plans may still approve coverage for treatment with an out-of-network authorization. For non-emergent services, both an out-of-network authorization and single case agreement must be in place before services are provided.
Emergency services at a Texas Children’s Hospital emergency department does not require any prior authorization or pre-treatment agreement.
Patients with questions regarding the out-of-network process should contact their health insurance plan.
Health Insurance Plan information applies to the following locations:
Texas Children’s Hospital Locations
- Texas Children’s Hospital
- Texas Children’s Pavilion for Women
- Texas Children's Hospital – North Austin
- Texas Children’s Hospital – West Campus
- Texas Children’s Hospital – The Woodlands
Texas Children's Specialty Care Locations
- Texas Children's Specialty Care - Austin
- Texas Children's Specialty Care - Bellaire
- Texas Children's Specialty Care - Cy-Fair
- Texas Children's Specialty Care - Clear Lake
- Texas Children's Specialty Care - Eagle Springs
- Texas Children's Specialty Care - Kingwood Glen
- Texas Children's Specialty Care - Sugar Land
- Texas Children's Specialty Care - Upper Kirby
- Texas Children's Pavilion for Women – Pearland
Community Maternal Fetal Medicine Clinic Locations
- Community Maternal Fetal Medicine Clinic - The Woodlands
- Community Maternal Fetal Medicine Clinic - Northwest Houston
- Community Maternal Fetal Medicine Clinic - West Houston
- Community Maternal Fetal Medicine Clinic - Sugar Land
- Community Maternal Fetal Medicine Clinic - Baytown
- Community Maternal Fetal Medicine Clinic – The Methodist Hospital
Below is a list of payers who are contracted with Texas Children’s Hospital, Texas Children’s Physician Service Organization, and Texas Children’s Anesthesiology. Please confirm Texas Children’s participation with your health plan as some benefit plans utilize narrow networks which may exclude Texas Children’s.
Facility-based physicians bill and collect independently for their services, and may not participate in the same insurance plans as Texas Children’s Hospital. You may receive a bill from a facility-based physician for the amount unpaid by your insurance plan.
Please confirm network participation directly with your health plan. Some Employer Group Plans may exclude Texas Children’s Hospital from their network.
| Product Name | Product Type |
|---|---|
| Aetna - HMO, POS, PPO | Commercial |
| Aetna Better Health (Texas) | Government |
| Aetna NME | Transplant |
| Alianza Monte Sanai | International |
| AmeriHealth Caritas (Out of State) | Government |
| AXA Assistance USA | International |
| Banco CentroAmericano de Integracion Economic | International |
| BCBS Blue Cross Blue Shield TX PPO/POS (Blue Choice) | Commercial |
| BCBS Blue Distinction Centers for Transplants | Transplant |
| BCBS Blue Essentials (FKA HMO Blue) | Commercial |
| BCBS BlueCrossBlueShield TX ParPlan | Commercial |
| BCBSTX Medicaid STAR, CHIP, STAR Kids | Government |
| Cigna Commerical Products - HMO, POS, PPO | Commercial |
| Cigna LifeSOURCE | Transplant |
| Cigna Local Plus | Commercial |
| Community First Health Plans STAR, CHIP, STAR Kids | Government |
| Community Health Choice CHIP | Government |
| Community Health Choice STAR | Government |
| First Health | Commercial |
| FirstCare Health Plans HMO/PPO | Commercial |
| FirstCare Health Plans STAR, CHIP | Government |
| Galaxy Health Network | Commercial |
| Generali Medico Compana de Seguros, S.A. | International |
| HealthSmart Preferred Care, Inc. | Commercial |
| HealthSmart Preferred Care, Inc. Accel/AP-3 Product | Commercial |
| Imagine Health (Smart Care Network) | Commercial |
| Independent Medical Systems | Commercial |
| INTERLINK Health Services | Transplant |
| Emerging Therapies FNA LifeTrac Health Services | Transplant |
| Molina Healthcare of Texas STAR, CHIP & STAR PLUS | Government |
| Multiplan, Inc. | Commercial |
| National Healthcare Solutions | International |
| Optum Healthcare (formerly United Resource Network) | Transplant |
| Quality Health Management, L.L.C. | International |
| RightCare from Scott & White Health Plan (STAR) | Government |
| Scott & White Health Plan | Commercial |
| Seguros Atlas | International |
| Seguros Inbursa, S.A. | International |
| Sendero Health Plans | Commercial |
| Superior HealthPlan STAR, CHIP & STAR Kids | Government |
| Superior STAR Health (Foster Care) | Government |
| Texas Children's Health Plan STAR, CHIP & STAR Kids | Government |
| Tricare West | Government |
| UnitedHealthCare Community Care - STAR | Government |
| UnitedHealthCare Community Care - STAR Kids | Government |
| UnitedHealthcare Community Care - CHIP | Government |
| UnitedHealthCare Community Care - STAR+PLUS | Government |
| USA Managed Care | Commercial |
| USFHP | Government |
| Product Name | Product Type |
|---|---|
| Aetna - HMO, POS, PPO | Commercial |
| BCBS Blue Cross Blue Shield TX PPO/POS (Blue Choice) | Commercial |
| BCBS Blue Essentials (FKA HMO Blue) | Commercial |
| BCBS BlueCrossBlueShield TX ParPlan | Commercial |
| Cigna Commerical Products - HMO, POS, PPO | Commercial |
| Evolutions Health Care | Commercial |
| First Health | Commercial |
| FirstCare Health Plans HMO/PPO | Commercial |
| FirstCare Health Plans STAR, CHIP | Government |
| Galaxy Health Network | Commercial |
| Independent Medical Systems | Commercial |
| Molina Healthcare of Texas STAR, CHIP & STAR PLUS | Government |
| Multiplan, Inc. (includes Beechstreet and PPONext) | Commercial |
| RightCare from Scott & White Health Plan (STAR) | Government |
| Scott & White Health Plan | Commercial |
| Sendero Health Plans | Commercial |
| Superior STAR Health (Foster Care) | Government |
| Superior HealthPlan STAR, CHIP & STAR Kids | Government |
| United Healthcare All Commercial Products | Commercial |
| TriCare West | Government |
| UnitedHealthcare Community Care - CHIP | Government |
| UnitedHealthCare Community Care - STAR+PLUS | Government |
| UnitedHealthCare Community Care - STAR | Government |
| UnitedHealthCare Community Care - STAR Kids | Government |
| USFHP | Government |
Market place plans - OUT OF NETWORK
(individual plans through www.Healthcare.gov)
- Molina Healthcare
Out of Network Authorization is require by all market place plans prior to seeking care at Texas Children’s.
Transplant centers of excellence
The Transplant Program at Texas Children’s Hospital is dedicated to providing the highest quality of care to children needing heart, lung, liver or kidney transplantation through evidenced-based practices, research and education.
| Transplant Network | Heart | Kidney | Liver | Lung | BMT | CHD | ACHD | VAD | CAR-T |
|---|---|---|---|---|---|---|---|---|---|
| Aetna Institute of Excellence | X | X | X | X | X | X | N/A | X | N/A |
| Blue Distinction Centers for Transplants | X | N/A | X | N/A | X | N/A | N/A | N/A | N/A |
| Cigna LifeSOURCE Transplant Network | X | X | X | X | X | N/A | N/A | X | X |
| Humana National Transplant Network | X | X | X | X | X | N/A | N/A | N/A | N/A |
| INTERLINK Medical Excellence Programs | X | X | X | X | X | X | N/A | X | N/A |
| Emerging Therapy Solutions | X | X | X | X | X | X | N/A | X | X |
| Optum Centers of Excellence | X | X | X | X | X | X | X | N/A | N/A |
CHD = Congenital Heart Disease
VAD = Ventricular Assist Device