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PPO Health Insurance Plans in Texas

Preferred Provider Organizations are a form of health insurance coverage in which consumers may visit any doctor or hospital they choose, but have to pay more of the bill if they visit a doctor or facility outside the PPO network. Texas residents may choose from among a number of PPOs that provide coverage in their state.

  1. Blue Cross and Blue Shield of Texas

    • Founded more than 80 years ago, Blue Cross and Blue Shield of Texas is customer-owned rather than publicly-owned. It offers several PPO plans, each of which covers hospital care, surgical expenses and preventive care. BCBS says its provider network is among the largest in Texas, and for child immunizations, the PPO plans also cover all costs outside the network. The plans also cover many prescription drug costs.

    Aetna

    • Aetna offers several PPO plans in Texas, with your choice likely depending on how much you want to pay in monthly premiums versus how much you want to pay in deductibles and co-pays when you need care. For example, the Aetna PPO 1000 plan features an annual deductible of $1,000 and maximum out-of-pocket costs of $2,500 for an individual. These totals are relatively low, but the plan also includes moderately high premiums. The premiums are lower for the PPO 5000 plan, but the annual deductible is $5,000 and the out-of-pocket maximum is $7,500 for an individual.

    Humana One

    • Humana has headquarters in Louisville, Kentucky, and has existed in some form since 1961. Its national PPO network allows consumers to choose from more than 300,000 health care providers in 50 states, including more than 28,000 doctors and nearly 300 hospitals in Texas. As is typical in PPO plans, Humana establishes a yearly out-of-pocket limit for consumers. If you reach that limit, the plan pays all of your remaining covered expenses for the year. You would still owe co-payments, however.

    CIGNA

    • Texas is one of 10 states in which CIGNA offers individual and family plans. Its Open Access Plan is a PPO with 500,000 participating health care providers around the country, including 50,000 physicians and specialists and 200 hospitals in Texas. CIGNA also features Convenience Care Clinics for run-of-the-mill maladies. These clinics are in many pharmacies and supermarkets and feature nurse practitioners and physician assistants who can treat common illnesses and disorders. Co-payments and deductibles apply as they would for a visit to an in-network doctor's office.

    Medicare PPO

    • Medicare participants may purchase additional coverage and flexibility with a Medicare Advantage plan. In Texas, Care Improvement Plus administers a Medicare Advantage PPO. The monthly premium covers Medicare Part A (hospital expenses), Part B (general medical expenses and doctor bills) and Part D (prescription drug costs). A Medicare PPO plan also allows consumers to visit any Medicare-approved doctor or health care facility, with no requirement to get a referral first. It also includes coverage for vision, dental, podiatry and transportation.

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