Insurance Changes to Individual Policies
Both Blue Cross Blue Shield of Texas and Humana eliminated their PPO individual plans in 2016. This does not affect PPO plans that are offered by employers. It also does not affect PPO plans that were created before March 23, 2010, and have not been altered. Those are considered “grandfathered”. If you do not select another health insurance, Blue Cross Blue Shield and Humana will automatically move you to their HMO Products.
With the many changes in the healthcare industry, please contact your insurance company to confirm that Beansprout Pediatrics tax ID # 271766809 is an "in-network provider" for your particular plan. It is the parents responsibility to verify whether or not your doctor is an in-network provider for your insurance
Insurance plans Beansprout accepts
Blue Advantage HMO & Blue Advantage Plus HMO: Beansprout Pediatrics is participating in these plans. Prior to seeing any specialist, per your plan contract, you are required to first see your primary care provider for the medical issue. This allows Beansprout to obtain referral approval to see the recommended specialist. This process may take up to 7 days. These plans have a very limited number of specialty providers in network. With very few specialists in the network, obtaining referrals for specialty care, like cardiology, and gastroenterology, is very difficult. this may negatively impact the care we recommend to our patients. Blue Advantage Plus HMO is similar to the HMO, but has out of network benefits, Therefore, you may see a Beansprout provider, although you will have higher out of pocket expenses because we are out of network.
United Compass Products: Beansprout Pediatrics is participating in this plan. United Compass is a closed network; therefore there may be limited specialists in this network. Please note, this plan limits hospital services to only St. David’s facilities. Seton is not participating, this includes all pediatric specialists through Dell, Specially for Children
Aetna EPO: Beansprout Pediatrics is participating in Aetna EPO Products. These are available through the Aetna website and healthcare.gov. Please note, this plan limits hospital services to only Seton facilities. St David’s is not participating
Aetna: Austin PPO. Austin HMO. Austin HMO Open Access Manage Plan & Save Plus, Save & Maximum
Blue Cross Blue Shield: PPO. HMO Blue. *Blue Advantage HMO (Health Care exchange plan).
Cigna : Open Access PPO. Open Access HMO
Health First Plans
Humana: Choice Care PPO & HMO
Scott & White HMO & PPO
Seton Physician Health Network SPHN
The Loomis Co
United Health Care: PPO. POS. Choice HMO. *All Compass plans included (Health Care exchange plans). .
Beansprout is not "in network" & does not accept the following plans
Humana HMOX: Beansprout Pediatrics is NOTparticipating in this plan. Humana HMOX is a closed network. Since the plan inception in 2015, Beansprout Pediatrics has requested participation. However, Humana closed the plan to new providers at its inception. Please note, this plan limits hospital services to only Seton facilities. St David’s is not participating. We will notify our patients as soon as we are considered in network with this plan.
Aetna Advantage QHP
Cigna – Local Plus
Cigna – Local Plus IN
Cigna – Choice Fund Local Plus
Humana HMO X *Health Care Exchange Plan
Medicaid/CHIP/Star Health / Star Plus
newborns and insurance
Many new parents are unsure how insurance works for their new baby. Most insurance plans will cover the baby automatically for the first 30 days under mom's policy, but not all do. Contact your insurance company customer service department and your HR department about what's required to add the baby to your policy.