Insurance Plans

 

JPS Health Network and its affiliated facilities are contracted with the following insurance companies and provider networks to provide services to covered members at in-network benefit levels. We always recommend that you contact the insurance company to confirm eligibility and pre-certify services and procedures.

If you have questions about any of these plans, call the number listed on your Member ID Card or the general Member Services phone number listed by your Insurer below. 

 

 

An important notice for JPS Connection members

Patients who qualify for insurance through the Affordable Care Act must sign up in order to be eligible for JPS Connection.

To be eligible for JPS Connection, you must first take full advantage of all other assistance available to you. If you qualify for insurance from the Marketplace, you must sign up.

You can read more about the new Marketplace at HealthCare.gov (CuidadoDeSalud.gov) or call the Marketplace Call Center at 1-800-318-2596. Information on JPS Connection is here.

November 1: Open Enrollment starts for health coverage for the next plan year — first day you can enroll in, re-enroll in, or change health plans through the Health Insurance Marketplace®. Coverage can start as soon as January 1.

December 15: Last day to enroll in or change plans for coverage to start January 1.

January 1: Coverage starts for those who enroll in or change plans by December 15 and pay their first premium.

January 15: Open Enrollment ends — last day to enroll in or change health plans for the year. After this date, you can enroll in or change plans only if you qualify for a Special Enrollment Period.

February 1: Coverage starts for those who enroll in or change plans December 16 through January 15 and pay their first premium.

 


Marketplace Exchange Insurance Plans accepted at JPS

If you are signing up for Affordable Care Act insurance and want to use your insurance at JPS, below is a list of Affordable Care Act insurance plans currently contracted with JPS Health Network.

Important: Not all physicians are contracted with these plans. It is recommended that you verify with the Affordable Care Act representative or your physician to determine if your physician is in-network with the plan you have chosen.

 

Aetna

Ambetter Everyday Gold

Ambetter Standard Gold

Ambetter Complete Gold

Ambetter Everyday Gold+Vision+Adult Dental

Ambetter Standard Gold+Vision+Adult Dental

Ambetter Complete Gold+Vision+Adult Dental

Ambetter Standard Silver

Ambetter Focused Silver

Ambetter Complete Silver

Ambetter Focused Silver+Vision+Adult Dental

Ambetter Complete Silver+Vision+Adult Dental

BCBSTX

Blue Advantage Bronze HMO Standard

Blue Advantage Bronze HMO 204

Blue Advantage Plus Bronze 305

Blue Advantage Plus Bronze Standard

Blue Advantage Plus Bronze 303

Blue Advantage Gold HMO 206

Blue Advantage Gold HMO 706

Blue Advantage Plus Gold 803

Blue Advantage Plus Gold 203

Blue Advantage Plus Gold Standard

Blue Advantage Silver HMO 205

Blue Advantage Silver HMO Standard

Blue Advantage Plus Silver 202

Blue Advantage Plus Silver Standard

Blue Advantage Plus Silver 605

Cigna

Molina Healthcare

Wellpoint Marketplace (January 2025)

 

Español

 

 

Commercial Products

 

Aetna Commercial

 

Baylor Scott and White Health Plan

 

BCBS of Texas

 

 

HealthSmart

 

Molina Healthcare of Texas

 

MultiPlan

 

Prime Health Services

 

Three Rivers Provider Network

 

 

TriWest

 

United Healthcare

 

USA Managed-Care Organization

 


Medicare Products

 

 

American Health Plan

 

Baylor Scott and White Health Plan

 

BCBS of Texas Medicare

 

Cigna HealthSpring

 

Molina Healthcare of Texas

 

Superior Health Plan (Allwell)

 

United Healthcare Medicare Advantage

 

Wellcare by Allwell

 

 


Medicaid Products

 

Aetna Better Health of Texas (STAR , CHIP, and CHIP PERINATE)

 

Baylor Scott and White Health Plan

 

Cook Children's Health Plan (STAR, CHIP)(Includes Behavioral Health)

 

Molina Healthcare of Texas (STAR, STAR KIDS, STAR+PLUS, CHIP, CHIP PERINATE)

 

Point Comfort Underwriters

 

Superior Health Plan (STAR, STAR+ PLUS, STAR KIDS, STAR HEALTH, CHIP, CHIP Perinate)

 

United Healthcare (STAR+ PLUS)

 

Wellpoint (STAR, CHIP, and STAR PLUS)

 


Behavioral Health Products

 

Aetna Healthcare

 

BCBS of Texas

 

Baylor Scott and White Health Plan

 

Carelon

 

Evernorth Behavioral Health

 

Magellan Healthcare

 

Superior Health Plan (STAR, STAR+ PLUS, STAR KIDS, STAR HEALTH, CHIP, CHIP Perinate)

 

 

TriWest

 

United Behavioral Health/Optum

 


Workers Compensation Products

 

Prime Health Services

 

Rockport Community Network

 

Three Rivers Provider Network

 

USA Managed-Care Organization

 

 

Welcome to Medicare

As a JPS patient turning 65, we’d like to provide you with some information regarding Medicare enrollment and continued benefits offered at JPS.

Who is Eligible for Medicare?
Generally, Medicare is available for people 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). Medicare has four parts:

  • Part A (Hospital Insurance) helps pay for inpatient hospital stays, skilled nursing facility care, home healthcare, and hospice.
  • Part B (Medicare Insurance) helps cover medically necessary services like doctor visits and outpatient care. Part B also covers many preventive services (including screening tests and shots), diagnostic tests, some therapies, and durable medical equipment like wheelchairs and walkers. Together Part A and Part B are also referred to as “Original Medicare”.
  • Part C (Medicare Advantage Plan [MA]) is another way to get your Medicare benefits. I combines Part A, B, and sometimes D (prescription drug coverage). MA plans are managed by private insurance companies approved by Medicare. These plans cover medically necessary services. However, plans can charge different co-payments, co-insurance, or deductibles for these serves than Original Medicare.
  • Part D (Medicare Prescription Drug Coverage) helps pay for outpatient prescription drugs. Part D may help lower your prescription drug costs and protect you against higher costs in the future.

Initial Enrollment Period
You can first enroll during your Initial Enrollment Period (IEP), which lasts seven months.

  • Begins three months before your 65th birthday
    • Includes the month of you turn 65
  • Ends three months after you turn 65
    • Your start date will be delayed
    • To find out if you are eligible and your expected premium, go to Medicare.gov

General Enrollment Period (GEP)
People who did not sign up during the Initial Enrollment Period (IEP) can sign up during General Enrollment Period. There may be a penalty for signing up after your IEP.

  • January 1 - March 31 annually
    • Coverage starts July 1

Benefits offered at JPS

  • Continue care with your trusted JPS doctors
  • Personal one-on-one assistance with enrollment
  • Welcome to Medicare Comprehensive visit
  • Financial assistance to those who qualify to assist with out-of-pocket costs for hospital and pharmacy care
  • Medicare hotline (for questions and enrollment assistance)
  • Quarterly Medicare Education Sessions (in-person and online)
    • What is Medicare?
    • What are my coverage options?
    • How to enroll?
    • How do I use my Medicare?

Need Assistance?
JPS is here to help you with your Medicare questions.

  • JPS Medicare Hotline: 817-702-5233 (Monday - Friday | 8 a.m. - 4:30 p.m.)

Other Available Resources

  • Online: Medicare.gov
  • 1-800-Medicare (1-800-633-4227)
    • 24 hours a day, 7 days a week (except some federal holidays)

For Medicare plans accepted at JPS please see Accepted Insurance Plans above.

 

 

JPS Health Network and Acclaim Physician Group no longer accept Out of Network insurance. Patients with Out of Network insurance will be solely responsible for payment for all services starting January 1, 2024.

To find health insurance plans that JPS and Acclaim accept, please click https://www.jpshealthnet.org/financial-resources/insurance-plans. If you have questions or need assistance, please call 817-702-6704 or email PatientAccounts@jpshealth.org.