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Health Insurance Options

Health Insurance

Choose the Plan that Covers the Provider and Hospital You Trust.

Trinity Mother Frances providers and hospitals are NOT in-network for the Public Exchange/Health Insurance marketplace products.

But, there are a number of other coverage options in which TMFHC is in-network, including your employer's Blue Cross Blue Shield PPO plan. Other alternatives can be accessed through numerous trusted independent insurance agents/brokers across East Texas.

Please read the commonly asked questions below to help you make an informed decision about your healthcare.

Q: With which health insurance plans is Trinity Mother Frances in-network?

Contracted Insurance Plans

Trinity Mother Frances Hospitals and Clinics accept most major insurance plans providing health care coverage. The following is a list of health insurance companies and PPO networks with which Trinity Mother Frances is currently contracted as a participating provider.

Trinity Mother Frances Hospitals and Clinics’ participation with any product or insurance plan is subject to change without notice. Additionally, insurance companies offer a variety of plans and may change the names and benefits at any point. A patient’s level of coverage and access to Trinity Mother Frances depends on the specific benefits outlined in their plan.

To ensure that Trinity Mother Frances hospitals and physicians are in-network, it is the patient’s responsibility to verify that Trinity Mother Frances is a participating provider and their benefit plan allows them access as of the day of a visit and/or admission.

Commercial

Aetna PPO
Blue Cross Blue Shield HMO Blue Texas
PPO
PAR
*Excludes Blue Advantage HMO
Cigna PPO
All other products
Coventry/First Health
HealthPlan of Texas All products
HealthSmart Accel Network
PPO Network
Humana PPO
PHCS
United Healthcare *Excludes Compass products
USA MCO

Health Insurance Marketplace

As of January 1, 2016, TMFHC will not be in-network for any of the insurance products offered through the online public exchange/Health Insurance Marketplace (healthcare.gov)
* There are a number of other coverage options in which TMFHC is in-network.  These alternatives can be accessed through numerous trusted independent insurance agents/brokers across East Texas.

Managed Medicaid

Amerigroup
Cigna HealthSpring Star Plus
Molina
Superior Health Plan
United Healthcare Star Plus

Medicare Advantage

Aetna HMO
PPO
Cigna HealthSpring HMO
PPO
Humana HMO
PPO
Scott and White Health Plan SeniorCare
United Healthcare PPO

Medicare, Medicaid and Other Government Programs

Humana Military/TRICARE Standard
Medicaid
Medicare
Texas Department of State Health Services (DSHS)
Texas Department of Assistive and Rehabilitative Services (DARS)

Medicare Supplement Select Plans

For information on Medicare Supplement Select Plans call 903-510-8796.

Student Insurance

For information on Student Insurance call 903-531-5812.

Vision

Block Vision
Davis Vision
EyeMed
Opticare
Superior Vision

Workers' Compensation

Aetna
Coventry/First Health
Rockport Healthcare Group
Texas Workers’ Compensation Commission (TWCC)

Q: What is a public exchange/Health Insurance Marketplace?

A: A provision of the Affordable Care Act calls for the government to create public exchanges, an online Marketplace that will allow both uninsured and insured consumers the opportunity to shop for insurance coverage that best fits their budget and individual needs. In addition, there are cost sharing subsidies available to individuals and families who meet eligibility requirements. December 15, 2015 is the last date to enroll for coverage that starts on January 1, 2016.

Q: Will the plan I purchase on the public exchange/Health Insurance Marketplace allow me to continue to seek care at Trinity Mother Frances Hospitals and Clinics?

A: It’s important to note that as of January 1, 2016 TMFHC is not included in the insurance products offered through the online public exchange/Health Insurance Marketplace.


If you have a Trinity Mother Frances physician and want to continue to use Trinity Mother Frances Hospitals & Clinics, you will need to choose a plan outside the public exchange/Health Insurance Marketplace. By choosing an “off the market” in-network plan you will have access to all Trinity Mother Frances hospitals and providers. If you choose a plan that does not include Trinity Mother Frances Hospitals and Clinics, you could be responsible for up to 100 percent of costs.

Q: How will a public exchange/Health Insurance Marketplace affect my coverage if I have Medicare?

A: There will be no effect to you if you are on Medicare. You already have coverage through Medicare, and you do not need to make any changes.

Q: How will the public exchange/Health Insurance Marketplace know whether I am eligible for Medicaid?

A: The public exchange/Health Insurance Marketplace is equipped to evaluate the eligibility of individuals for Medicaid or financial assistance. Once eligibility is determined, the public exchange/Health Insurance Marketplace will help direct individuals to health insurance plans that meet their needs.

Q: How can I determine if I am eligible for Medicaid or financial assistance?

A: Individuals can determine if they are eligible for Medicaid or financial assistance in four ways: online at www.HealthCare.gov, by phone at (800) 318-2596, by mail, or in-person with the help of a trained assistant or navigator. Additional information is available by visiting www.HealthCare.gov or calling (800) 318-2596.

Q: Will there be out-of-pocket costs and co-pays for plans offered on the public exchange/Health Insurance Marketplace?

A: As with all health insurance plans, there will be different levels of out-of-pocket expenses and co-pays based on the type of insurance selected. Typically, if an individual has a higher monthly premium, he/she usually pays less out-of-pocket costs. A person may find it beneficial to select a higher premium insurance to avoid large out-of-pocket expenses and to minimize any pre-service deposit requirements for non-emergency care.

Q: Where can I find more information?

A: To find more information about public exchanges/Health Insurance Marketplaces, visit the Center for Medicare and Medicaid Services’ Marketplace website at www.HealthCare.gov, or call (800) 318-2596 (24 hours a day, 7 days a week).

For more information on Health Insurance Marketplace plans that include Trinity Mother Frances Hospitals and Clinics, call (903) 606-6266 or submit a request online.

Information Request

For more information on Health Insurance Marketplace plans that include Trinity Mother Frances Hospitals and Clinics, call (903) 606-6266 or submit a request online.