Managed Care Organization - MCO
What is a managed care organization?
HHSC contracts with managed care organizations, licensed by the Texas Department of Insurance. The health plans contract directly with doctors and other health care providers to create provider networks their members can use. The health plans are required to provide all covered medically necessary services to their members.
What is a provider network?
Provider networks are organizations of health care providers that deliver services within managed care health plans. Managed care enrollees are expected to use network providers.
In Texas, there are four types of Medicaid: STAR, STAR+PLUS, STAR Health, and traditional Medicaid. The type of Medicaid coverage a person gets depends on where the person lives and what kind of health issues the person has.
MCO’s we work with:
- United HealthCare Services
- Amerigroup
- Texas Children’s Health Plan
