ACCEPTED INSURANCE PLANS
Important It is the patient's responsibility to know the stipulations of their insurance policy, including referral & fee policies. Lake Pointe Orthopaedics is not responsible for educating the patient of changes in their benefits or policy. We recommend that the patient verify coverage/benefits with their insurance carrier before their appointment, as well as ensure proper referrals have been requested and sent to our office before their scheduled appointment. Insurance participation changes frequently. If you do not see your plan listed, please call us at (972) 475-8914.
Last updated June 2026
COMMERCIAL PLANS
- Aetna (PPO, POS, HMO, Open Access, Select)
- Blue Cross Blue Shield of Texas – Blue Choice PPO
- Blue Cross Blue Shield of Texas – Blue Essentials
- Blue Cross Blue Shield of Texas – HealthSelect of Texas (ERS)
- Blue Cross Blue Shield of Texas – Federal Employee Program (FEP)
- Blue Cross Blue Shield of Texas – Traditional/Indemnity
- Cigna (PPO, HMO, POS, Open Access Plus)
- Coventry/First Health (PPO, HMO, POS)
- Galaxy Health Network (PPO)
- HealthSmart (PPO, EPO Preferred, Accel)
- PHCS/Multiplan (PPO)
- United Healthcare (Choice, Choice Plus, Select, Select Plus, Options PPO, Core, Navigate, All Savers)
- United Healthcare – UMR
- USA MCO (PPO)
MARKETPLACE (ACA) PLANS
- Ambetter by Superior HealthPlan (Ambetter Premier)
- Blue Cross Blue Shield of Texas – MyBlue Health
MEDICARE PLANS
- Original Medicare
- Blue Cross Medicare Advantage (PPO and HMO)
- Humana Medicare Advantage (HMO, PPO, Honor, Gold Choice)
- Molina Medicare Advantage
- Superior HealthPlan/Wellcare by Allwell Medicare
- United Healthcare/AARP Medicare Advantage
- WellCare Medicare (HMO)
- Wellpoint Medicare Advantage
MEDICAID & CHIP PLANS (STAR, STAR KIDS, CHIP)
- Aetna Better Health
- Blue Cross Blue Shield of Texas
- Cook Children’s Health Plan
- Molina Healthcare
- Parkland Community Health Plan
- Superior HealthPlan
- United Healthcare Community Plan
- Wellpoint (formerly Amerigroup)
MILITARY & VETERAN PLANS
- Tricare West (Prime, Select, Reserve, Young Adult, Tricare for Life)
- TriWest (VA Community Care Network)
PLANS WE DO NOT CURRENTLY ACCEPT
- Aetna Medicare Advantage (as of January 1, 2025)
- Cigna Connect and Cigna Simple Choice (Marketplace plans)
- Ambetter HMO Value
- Aetna CVS, United Healthcare, and Wellpoint Marketplace plans
If your plan is not listed above, please contact our office. Our team is happy to help you understand your options.
WORKERS’ COMPENSATION HEALTH CARE NETWORKS
- Aetna
- Argus Provider Network
- Beech Street
- Bunch and Association, Inc. TX HCN
- Cigna Workers HCN
- CMI Barron Risk Management
- Concentra Health Care Network
- Coventry
- Corvel HealthcareCorp
- First Health/AIG TX HCN
- First Health TX HCN
- Focus HCN
- Forte Inc./First Health
- Hartford Workers Comp HCN
- Health E Innovations
- International Rehab Associates/Intracorp
INSURANCE TERMINOLOGY AND DEFINITIONS
EXCLUSIVE PROVIDER ORGANIZATION (EPO)
Form of managed care in which participants are reimbursed only for care received from affiliated providers.
HEALTH MAINTENANCE ORGANIZATION (HMO)
A plan that offers a variety of services including physical exams, education, and preventative medicine programs, in exchange for a fixed-monthly premium. An HMO may be an independent company, or it may be sponsored by an employer, insurance company, hospital, union, or government agency. Members either select or are assigned a primary care physician who is responsible for all referrals in providing adequate patient care.
INDEMNITY INSURANCE
Insurance policies through which benefits are paid in a predetermined amount for a covered loss. Usually, the insured person receives services and submits a claim to the insurer, and providers are paid fees for the services rendered.
MARKETPLACE (ACA) PLAN
A health plan purchased through the Health Insurance Marketplace established by the Affordable Care Act. Marketplace plans are often network-restricted, so it is especially important to verify that a specific provider is in network before your visit.
MEDICARE ADVANTAGE
A Medicare plan offered by a private insurance company as an alternative to Original Medicare. These plans often have their own provider networks and referral requirements, which can change each year during open enrollment.
POINT OF SERVICE (POS)
Plans tend to be more flexible than HMOs, but also require you to select a Primary Care Physician (PCP). Depending on insurance stipulations, the patient may choose to visit a doctor outside the network and still receive coverage, but the amount covered will be substantially less than if using a physician within the network. Some plans may require the patient to pay up-front and submit the claim for reimbursement.
PREFERRED PROVIDER ORGANIZATION (PPO)
A network of physicians and hospitals that provides an insurance company or employer with discounts for its services. Consumers covered by a PPO are allowed to use providers outside the PPO network, including specialists whenever they choose, for an additional expense.