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Insurance and Billing

Explore a list of insurance plans that UT Health Austin currently accepts as well as FAQs regarding billing.

Insurance

  • AARP Medicare Complete Focus HMO
  • AARP Medicare Complete Focus Essential HMO
  • Accountable Health Plan/Interplan
  • Aetna Whole Health
  • Aetna Medicare Advantage
  • Aetna PPO/HMO (Not contracted with marketplace plans)
  • Aetna Seton Health Alliance
  • Ambetter-Superior Health Plan -Exchange Plan
  • Amerigroup/Amerivantage Classic (Ophthalmology Clinic does not accept Medicaid Plan)
  • Ascension Complete (Medicare Advantage Plan)
  • Ascension Personalized Care
  • Beech Street PPO (SPHN)
  • Blue Cross Blue Shield (Also accepted by the Ambulatory Surgery Center)
  • Blue Cross Blue Shield Blue Essentials/Blue Essentials Access - Exchange Plan
  • Blue Cross Blue Shield Blue Choice PPO/UT Select
  • Blue Cross Blue Shield Blue Advantage HMO/Health Select
  • Blue Cross Blue Shield Medicaid (STAR/STAR PLUS/CHIP/STAR KIDS)
  • Blue Cross Blue Shield Medicare Advantage (Also accepted by the Ambulatory Surgery Center)
  • Blue Cross Blue Shield PAR Plan
  • Blue Cross Blue Shield UT Care (Medicare Advantage Plan)
  • Cigna- All plans
  • Cigna Behavioral Health
  • Coventry (SPHN)
  • Dell Children’s Health Plan STAR/CHIP
  • EHN/WEB TPA - (Whole Foods)
  • First Health (SPHN)
  • First Care Access PPO Network (SPHN)
  • Firstcare HMO (SPHN)
  • Galaxy (SPHN)
  • Health Payors Organization (SPHN)
  • Healthsmart (SPHN)
  • Humana Medicare Advantage- Primary Care Providers are out of Network for Humana Gold Plus
  • Humana HMOx
  • Humana PPO/HMO/Choice Care
  • Integrated Medical Systems PPO (SPHN)
  • Magellan
  • MAP/MAP BASIC – (limited to Advanced Imaging, the Musculoskeletal Institute, Women’s Health, Post-COVID-19 Program, Mitchel and Shannon Wong Eye Institute)
  • Medicaid/TMHP (the Walk-In Clinic is not available for Medicaid plans) (Also accepted by Ambulatory Surgery Center)
  • Medicare Part B Traditional fee for service (Novitas) (Also accepted by Ambulatory Surgery Center)
  • Multiplan (PHCS is out of network)
  • Optum
  • Oscar Healthcare
  • Sana Insurance (Also accepted by the Ambulatory Surgery Center)
  • Seton Health Plan Smarthealth
  • Sendero IdealCare
  • Superior Health Plan STAR/CHIP/STAR KIDS
  • Triwest (Also accepted by Ambulatory Surgery Center)
  • United Healthcare (Not contracted with marketplace plans)
  • United Healthcare AARP PPO (Also accepted by the Ambulatory Surgery Center) (Not contracted with marketplace plans)
  • United Healthcare Community Plan - Medicaid (Not contracted with marketplace plans)
  • United Healthcare Dual Complete Focus HMO (Not contracted with marketplace plans)
  • United Healthcare One (Not contracted with marketplace plans)
  • United Healthcare Medicare (Not contracted with marketplace plans)
  • United Healthcare All Savers/Choice/Choice Plus/HMO/PPO (Not contracted with marketplace plans)
  • United Student Resources PPO (SPHN)
  • USA Managed Care (SPHN)
  • Wellcare
  • Wellmed:
    • Amerivantage Select HMO
    • AmerivantageDual Coordination HMO
    • Humana Gold Plus HMO
    • Humana Gold Plus /Any Humana Medicare Advantage HMO Plans
    • Medicare Replacement/Advantage (Also accepted by Ambulatory Surgery Center)

Updated 10/16/23

Disclaimer: Insurance plans are subject to change at any time and without notice. A patient’s level of coverage depends on the specific benefits described in their plan. Patients are responsible for verifying that UT Health Austin is a participating provider and that their benefits plan allows them access to care on the day of their first scheduled visit. Please contact your insurance plan or benefits administrator to verify this information.

To verify that we accept your particular insurance plan, please call the UT Health Austin Access Center at 1-833-UT-CARES (1-833-882-2737).

Billing

Prior to Your Appointment:

  • UT Health Austin will verify your insurance
  • Be sure to check with your health insurance carrier for final determination regarding specific covered services since they are subject to change

Day of Service:

  • Bring a personal ID and your insurance card
  • Notify the staff of any additional medical insurance coverage
  • Verify your correct mailing address and let the staff know of any other changes since your last visit (e.g., phone numbers, employer, etc.)
  • Applicable co-payments, co-insurance, and deductible amounts will be collected

Following Your Visit:

  • You will receive an Explanation of Benefits (EOB) from your carrier
  • UT Health Austin will send you a bill for any remaining financial obligation not paid by your health plan

You can pay your bill online through your MyUTHA patient portal or by phone at 1-833-UT-CARES (1-833-882-2737).

UT Health Austin accepts most insurance plans in Central Texas. For patients without insurance or who prefer to pay cash, we offer self-pay options. Self-pay patients are offered a prompt pay discount or payment plans. For questions about our payment options, please ask to speak with an Access Center care team member when you call.

A patient who is uninsured and has no third party option will receive the following options:

  • 38% discount off UT Health Austin Fee Schedule in exchange for payment in full at the time of service, or
  • 25% discount off UT Health Austin Fee Schedule in exchange for establishing or establishing and adhering to a payment plan.

Patients will complete and sign an Uninsured Document Form.

The discounts above will be revoked if:

  • Payment in full is not made or a payment plan is not established

Original fees will be reinstated if a payment plan is not honored until payment in full is reached. For more information, please review the Uninsured/Self-Pay Policy here.

UT Health Austin provides Good Faith Estimates to those patients who request it.

Learn more about your rights for protection against surprise billing and to receive a good faith estimate from our clinic:

UT Health Austin is committed to helping prospective patients access care in a financially sustainable manner. Patients without current insurance coverage can receive assistance with determining eligibility for potential coverage options or may choose to participate in a self-pay plan.

As a state organization and part of The University of Texas System, charity care is available to residents of the state of Texas. Qualification is indexed to the Federal Poverty Index Level (FPIL) and potential patients must demonstrate that their income and relevant assets are at or below 200% of FPIL, pro-rated by family size. In 2019, 200% of FPIL is $51,500 annually for a family of four. In addition, proof of residency is required in the form of a driver’s license, social security card, and other accepted forms that can be found here. Complete details of the UT Health Austin Charity Care and Financial Assistance policy are available here.

If you believe you may be eligible for UT Health Austin financial assistance, please schedule an appointment with a UT Health Austin financial counselor. The financial counselor can assist you with determining eligibility for other coverage programs as well as UT Health Austin charity care. Please call 1-512-495-5875 for assistance. You may also fill out the Financial Assistance Contact Form and a member of our team will contact you.

Patients who do not qualify for Charity Care and cannot meet self-pay scheduled payments may be referred to:

<br>Non-Acute Needs

<br>Acute Need

The Coronavirus Aid, Relief, and Economic Security (CARES) Act includes a number of provisions to provide relief to the public due to issues caused by the pandemic, including price transparency for COVID-19 testing. Section 3202(b) of the CARES Act requires providers of diagnostic tests for COVID-19 to post the cash price for a COVID-19 diagnostic test on their website from March 27 through the end of the public health emergency. For more information, please review these FAQs.

At UT Health Austin, the self-pay cost for COIVD-19 screening and testing is $80.00 plus an additional lab charge for Clinical Pathology Laboratories of $70.00.