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Texas

Find Texas state highlights, local network coverage, expanded footprint details and more.

 

Coverage counties

Aransas, Bee, Bexar, Brazoria, Collin, Comal, Dallas, Denton, Duval, Ellis, El Paso, Fort Bend, Galveston, Guadalupe, Harris, Hays, Hunt, Jim, Johnson, Kaufman, Kendall, Kleberg, Montgomery, Parker, Rockwall, San Patricio, Tarrant, Travis, Wells, Williamson, Wise

 

State highlights

 

  • PCP and referrals required. Plan providers must be used to receive benefits. All plans offer nationwide access to in-network walk-in-clinics.
  • Outpatient mental health/substance abuse will follow PCP (not specialist) cost share. All plans include acupuncture; this benefit follows PCP cost-share and allows up to 10 visits per calendar year.
  • 24/7 $0 virtual care through MinuteClinic Virtual Care.
  • Plans include mental health at in-network providers.
  • Silver 4 State Mandated Plan with $0 deductible.

 

Network highlights

  • The retail pharmacy network is the Aetna® Managed Network. It consists of over over 52,000 pharmacies nationwide, including but not limited to: Brookshire Brothers, Costco, CVS Pharmacy®, HEB, Rite-Away Pharmacy, Sam’s Club and Walmart. Find all participating pharmacies in your area.
  • Four prescription tiers for all Aetna CVS Health® ACA plans: 1) Preferred generic, 2) Preferred brand, 3) Non-Preferred Generic*** and Brand and 4) Preferred and non-preferred specialty.
  • For CMS Standard Plans, all generics are in Tier 1 (Generic Preferred).
  • All plans include a drug list and Preferred Pharmacy Network.

Network providers in our service areas below include, but are not limited to:
 

Austin
 

  • All hospitals are part of the HCA St. David’s hospital

 

Corpus Christi
 

  • Corpus Christi Medical Center - Bay Area
  • Corpus Christi Medical Center - The Heart Hospital
  • Corpus Christi Medical Center - Doctors Regional
  • Corpus Christi Medical Center - Northwest Behavioral Health Center

 

Dallas
 

  • Medical City Hospitals (HCA)
  • Methodist Hospital System

 

El Paso
 

  • HCA Del Sol Medical Center
  • Las Palmas Del Sol Healthcare

 

Houston
 

  • HCA Houston Healthcare
  • Kelsey-Seybold Clinics
  • CHI St. Luke’s Health Baylor College of Medicine Medical Center

 

San Antonio
 

  • HCA Methodist Hospital System

Publication

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Lower your premiums brochure

Texas market summary

ACA individual & family plan brochure (Texas)

Consumer choice plan form - new members

Consumer choice plan form - renewal members

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Lower your premiums brochure

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Publication

Texas market summary

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Publication

ACA individual & family plan brochure (Texas)

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Publication

Consumer choice plan form - new members

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Publication

Consumer choice plan form - renewal members

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Check out our plans – there may be one for your clients!

 

Open Enrollment has ended. But your clients can still get coverage if they've had a big life change that qualifies them for a Special Enrollment Period. Simply search your client's ZIP code to see if our plans are in their area.

 

Great news — we’ve got plans in your area

 

If you’re a current Aetna® broker, visit Producer World® to access our quote and enroll tool.

 

Not a current broker? Join our team.

Get appointed with us

 

We’re not in your area … yet

We’ve got plans to bring our ACA individual & family plans to more areas. For now, let’s make sure your clients are covered.

 

If your client had a big life change, they can still get coverage. Visit the Health Insurance Marketplace® to shop for plans and see if they qualify for financial help.

 

Find a plan on HealthCare.gov

 
 

Great news — we’ve got plans in your area through our relationship with [JV_Partner]

 

If you’re a current Aetna® broker, visit Producer World® to access our quote and enroll tool.

Log in to Producer World

 

Not a current broker? Join our team.

Get appointed with us

 

For all Nevada counties:


If your clients qualify for a Special Enrollment Period, they can start their shopping experience for Aetna CVS Health® plans by visiting the Nevada Health Link.

 

For all California counties:


If your clients qualify for a Special Enrollment Period, they can start their shopping experience for Aetna CVS Health® plans by visiting Covered California.

 

For all New Jersey counties:


If your clients qualify for a Special Enrollment Period, they can start their shopping experience for Aetna CVS Health® plans by visiting Get Covered New Jersey.

 

We’re here to help

 

Call your broker support line

 

Our dedicated representatives are here to answer all your questions.

 

1-844-383-6130 (TTY: 711)

Call us Monday — Friday, 8 AM to 9 PM ET.

 

*For a complete list of participating walk-in clinics, use our provider lookup. Includes select MinuteClinic services. Not all MinuteClinic services are covered. Please consult benefit documents to confirm which services are included. This benefit is not available in all states. Access to MinuteClinic and other participating walk-in clinics may vary by geography. Walk-in appointments are based on availability and not guaranteed. Online scheduling is recommended.

**Check your plan documents for coverage information. Some plans may cover all generics, including nonpreferred generics, at the lowest cost tier.

Legal notices

Health plans are offered or underwritten or administered by Aetna Health of California Inc., Coventry Health Plan of Florida, Inc., Aetna Health Inc. (Florida), Aetna Health Inc. (Georgia), Aetna Life Insurance Company, Aetna Health of Utah Inc., Aetna Health Inc. (Pennsylvania), or Aetna Health Inc. (Texas) (Aetna). Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic branded walk in clinics) are part of the CVS Health® family of companies.

Health benefits and health insurance plans contain exclusions and limitations.