Publication
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 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
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Lower your premiums brochure |
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Texas market summary |
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ACA individual & family plan brochure (Texas) |
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Consumer choice plan form - new members |
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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.
We’re here to help
Call your navigator support team
Our dedicated representatives are here to answer all your questions.
1-844-383-6125 (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.