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1 Advantage Plan MCO HHSC Contract Number CMS Code Plan ID Plan Name Type Counties Served Health Plan of Texas H Aransas, Bee, Jim Wells, Kleberg, Nueces, San Patricio Health Plan of Texas H Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina, Wilson Health Plan of Texas H Bowie, Cass, Collin, Dallas, Delta, Denton, Ellis, Fannin, Johnson, Kaufman, Red River, Rockwall, Tarrant, Titus, Wise Health Plan of Texas H El Paso Health Plan of Texas H Hayes, Travis, Williamson Health Plan of Texas H Anderson, Aransas, Atascosa, Bandera, Bee, Bexar, Bowie, Camp, Cass, Cherokee, Collin, Comal, Dallas, Delta, Denton, Ellis, El Paso, Fannin, Fort Bend, Franklin, Freestone, Gregg, Guadalupe, Hardin, Harris, Harrison, Hays, Henderson, Hopkins, Houston, Jefferson, Jim Wells, Johnson, Kendall, Kleberg, Marion, Medina, Montgomery, Morris, Navarro, Nueces, Panola, Red River, Rockwall, Rusk, San Patricio, Shelby, Smith, Tarrant, Titus, Travis, Trinity, Upshur, Van Zandt, Williamson, Wilson, Wise, Wood Health Plan of Texas H (- CHF/DM Anderson, Aransas, Atascosa, Bandera, Bee, Bexar, Bowie, Camp, Cass, Cherokee, Collin, Comal, Dallas, Delta, Denton, Ellis, El Paso, Fannin, Fort Bend, Franklin, Freestone, Gregg, Guadalupe, Hardin, Harris, Harrison, Hays, Henderson, Hopkins, Houston, Jefferson, Jim Wells, Johnson, Kendall, Kleberg, Marion, Medina, Montgomery, Morris, Navarro, Nueces, Panola, Red River, Rockwall, Rusk, San Patricio, Shelby, Smith, Tarrant, Titus, Travis, Trinity, Upshur, Van Zandt, Williamson, Wilson, Wise, Wood Advantage Plans Page 1 of 6

2 Health Plan of Texas H (- CHF/DM Anderson, Aransas, Atascosa, Bandera, Bee, Bexar, Bowie, Camp, Cass, Cherokee, Collin, Comal, Dallas, Delta, Denton, Ellis, El Paso, Fannin, Fort Bend, Franklin, Freestone, Gregg, Guadalupe, Hardin, Harris, Harrison, Hays, Henderson, Hopkins, Houston, Jefferson, Jim Wells, Johnson, Kendall, Kleberg, Marion, Medina, Montgomery, Morris, Navarro, Nueces, Panola, Red River, Rockwall, Rusk, San Patricio, Shelby, Smith, Tarrant, Titus, Travis, Trinity, Upshur, Van Zandt, Williamson, Wilson, Wise, Wood Health Plan of Texas H Harris, Fort Bend, Montgomery Health Plan of Texas H Group Kleberg, Nueces, San Patricio Health Plan of Texas H Group Atascosa, Bandera, Bexar, Comal, Kendall, Wilson Health Plan of Texas H Group Anderson, Camp, Cherokee, Franklin, Freestone, Gregg, Hardin, Harrison, Henderson, Hopkins, Houston, Jefferson, Marion, Morris, Navarro, Panola, Rusk, Shelby, Smith, Trinity, Upshur, Van Zandt, Wood Insurance Company of Scott and White H Vital Traditions () Collin, Dallas, Ellis, Johonson, Rockwall, Tarrant Insurance Company of Scott and White H Vital Traditions ( POS) Collin, Dallas, Ellis, Johonson, Rockwall, Tarrant SelectCare Health Plans H Classic () Collin, Dallas, Rockwall, Tarrant SelectCare of Texas H Classic () Austin, Brazoria, Chambers, Fort Bend, Galveston (77510, 77511, 77517, 77518, 77539, 77546, 77549, 77563, 77564,77568, 77573, 77574, 77590, 77591, 77592), Hardin, Harris, Jefferson, Liberty, Montgomery, Orange, Waller Advantage Plans Page 2 of 6

3 SelectCare of Texas H Value () Austin, Brazoria, Chambers, Fort Bend, Galveston (77510, 77511, 77517, 77518, 77539, 77546, 77549, 77563, 77564,77568, 77573, 77574, 77590, 77591, 77592), Hardin, Harris, Jefferson, Liberty, Montgomery, Orange, Waller SelectCare of Texas H Choice Austin, Brazoria, Chambers, Fort Bend, Galveston (77510, 77511, 77517, 77518, 77539, 77546, 77549, 77563, 77564,77568, 77573, 77574, 77590, 77591, 77592), Hardin, Harris, Jefferson, Liberty, Montgomery, Orange, Waller Texas H Advantage Angelina, Brazoria, Cameron, Chambers, Fort Bend, Hardin, Harris, Hidalgo, Jasper, Jefferson, Liberty, Montgomery, Nacogdoches, Newton, Orange, Polk, Sabine, San Augustine, San Jacinto, Shelby, Tyler, Walker, Waller and Willacy. Galveston (77510; 77511; 7517; 77518; 77539; 77546; 77549; 77563; 77565; 77568; 77573; 77574; 77590; 77591; 77592) Texas H Advantage Brazoria, Cameron, Chambers, Fort Bend, Hardin, Harris, Hidalgo, Jasper, Jefferson, Liberty, Montgomery, Newton, Orange, San Jacinto, Walker, Waller, Webb, Willacy, Angelina, Nacogdoches, Polk, Tyler, Galveston (77510; 77511; 7517; 77518; 77539; 77546; 77549; 77563; 77565; 77568; 77573; 77574; 77590; 77591; ) Texas H Preferred Bexar, Collin, Dallas, Denton, El Paso, Hood, Johnson, Parker,Tarrant, Wise Texas H Preferred Henderson, Lubbock, Rusk, Smith, Upshur, Van Zandt Advantage Plans Page 3 of 6

4 Advantage Special Needs Plan MCO HHSC Contract Number Amerigroup H CMS Code Plan ID Plan Name Type Counties Served Amerivantge Dual Coordination Bexar, ElPaso, and Travis Amerigroup H Amerivantge Dual Coordination Harris Amerigroup H Amerivantge Dual Coordination Brazoria, Fort Bend, Galveston, Jefferson, Montgomery, Denton, Tarrant, Hudspeth, Comal, Medina, Lubbock, Hays, and Williamson Care Improvement Plus R Dual Advantage All Counties Care Improvement Plus H Dual Advantage All Counties FirstCare H FirstCare Advantage Select Crosby, Ector, Floyd, Garza, Hale, Hockley, Jones, Lamb, Lubbock, Lynn, Midland, Potter, Randall, Taylor, Terry, Tom Green, Hill, DeafSmith, Carson, Swisher, Castro, Martin, McLennan, Hutchinson, Bauiley, Dickens, Cochran GHS Insurance H Blue Cross AdvantageDual Care Bastrop, Burnet, Caldwell, Hays, Lee, Williamson, ElPaso Health Plan of Texas H Gold Plus -DE Bowie, Cass, Collin, Dallas, Delta, Denton, El Paso, Ellis, Fannin, Fort Bend, Gregg, Harris, Harrison, Henderson, Johnson, Montgomery, Red River, Rockwall, Tarrant, Titus, Wise Health Plan of Texas H Gold Plus -De Aransas, Atascosa, Bandera, Bee, Bexar, Comal, Guadalupe, Jim Wells, Kendall, Kleberg, Medina, Nueces, San Patricio, Wilson Molina of Texas, Inc H Molina Options Plus Bexar, Cameron, Collins, Dallas, ElPaso, Harris, Hidalgo, Webb Advantage Plans Page 4 of 6

5 Molina of Texas, Inc H Molina Options Bexar, Cameron, Collins, Dallas, ElPaso, Harris, Hidalgo, Webb H Hays, Travis Williamson H Aransas, Kleberg, Nueces, San Patricio H El Paso H Cameron, Hidalgo, Willacy Superior H Superior HealthPlan Advantage Bexar, Nueces, Dallas, Rockwall, Collin Texas H TotalCare Angelina, Brazoria, Cameron, Chambers, Fort Bend, Galveston (77510; 77511; 7517; 77518; 77539; 77546; 77549; 77563; 77565; 77568; 77573; 77574; 77590; 77591; 77592), Hardin, Harris, Hidalgo, Jasper, Jefferson, Liberty, Montgomery, Nacogdoches, Newton, Orange, Polk, San Jacinto, Shelby, Tyler, Walker, Waller, Webb, Willacy Texas H Cigna-Health Spring TotaCare Bexar, Collin, Dallas, Denton, El Paso, Hood, Johnson, Parker,Tarrant, Wise Texas H TotalCare Cherokee, Grayson, Gregg, Henderson, Lubbock, Rains, Rusk, Smith, Upshur, Van Zandt, Wood Today's Options H Star Austin, Chambers, Fort Bend, Galveston, Hardin, Harris, Jefferson, Liberty, Matagorda, Montgomery, Newton, Orange, Polk, San Jacinto, Walker, Waller, Wharton Insurance Company H DP (PPO ) El Paso Advantage Plans Page 5 of 6

6 of Texas, LLC H HealthCare Bastrop, Brazoria, Burnet, Caldwell, Fort Bend, Galveston, Harris, Hays, Henderson, Jefferson, Liberty, Montgomery, Polk, Smith, Travis, Van Zandt, Waller, Williamson, and Wood Benefits of Texas, Inc H Colin, Dallas, Denton, Ellis, Johnson, Kaufman, Rockwall, Tarrant, Benefits of Texas, Inc H Atascosa, Bexar, Comal, Guadalupe, Kendall, Wilson, Benefits of Texas, Inc H Bee, Jim Wells, Kleberg Nueces, San Patricia WellCare H WellCare Access ElPaso WellCare H WellCare Access Bexar, Dallas, Denton, Fort Bend, Galveston, Harris, Jefferson, Johnson, Montgomery, Tarrant Advantage Plans Page 6 of 6

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