Medicaid plans › Texas
Texas Medicaid Managed-Care Plans for Providers
Enrollments are billed 50% at the start and 50% at submission; everything else 100% at the start.
Texas Medicaid is run by the Texas Health and Human Services Commission. 3,842,754 people were enrolled in its 15 managed-care plans in 2024. To see their patients, a provider enrolls with Texas Medicaid through the TMHP Provider Enrollment and Management System (PEMS), then applies to each plan separately.
| Plan | Members (2024) | Share | Parent |
|---|---|---|---|
| Superior HealthPlan | 950,499 | 24.7% | Centene |
| Wellpoint | 684,884 | 17.8% | Elevance Health |
| Texas Children's Health Plan | 417,218 | 10.9% | In-state |
| UnitedHealthcare Community Plan | 335,670 | 8.7% | UnitedHealth Group |
| Community Health Choice Texas | 264,093 | 6.9% | In-state |
| Molina Healthcare of Texas | 223,832 | 5.8% | Molina Healthcare |
| Driscoll Children's Health Plan | 194,012 | 5% | In-state |
| Parkland Community Health Plan | 156,752 | 4.1% | In-state |
| Baylor Scott & White Health Plan (Scott & White Health Plan and FirstCare Health Plans) | 125,192 | 3.3% | In-state |
| Community First Health Plans | 121,574 | 3.2% | In-state |
| Cook Children's Health Plan | 113,771 | 3% | In-state |
| Aetna Better Health of Texas | 113,659 | 3% | CVS Health |
| El Paso Health | 67,005 | 1.7% | In-state |
| Blue Cross and Blue Shield of Texas | 46,354 | 1.2% | Health Care Service Corporation |
| Dell Children's Health Plan | 28,239 | 0.7% | In-state |
How Joining Works in Texas
First the state: Texas Medicaid enrollment through the TMHP Provider Enrollment and Management System (PEMS), which gives you the Medicaid ID every plan asks for. Then the plans: each takes its own participation request and credentials you from your CAQH ProView (DataSpring) profile. 6 parent companies run plans here, and plans owned by the same company still contract state by state.
How to Join Each Texas Plan
Superior HealthPlan (Centene): Centene runs this plan alongside its Ambetter and Wellcare products. Each Centene plan takes its own contract request on the plan's provider website, credentials from your CAQH ProView (DataSpring) profile, and will not load a provider without the state Medicaid ID.
Wellpoint (Elevance Health): Elevance Health plans take participation requests through the plan's provider site for that state, most of them now inside Availity Essentials, and credential from your CAQH ProView (DataSpring) profile. Each state is its own contract.
UnitedHealthcare Community Plan (UnitedHealth Group): UnitedHealthcare Community Plans use UnitedHealthcare's provider onboarding: a participation request on the UnitedHealthcare provider site, credentialing from your CAQH ProView (DataSpring) profile, then a state-specific Community Plan agreement.
Molina Healthcare of Texas (Molina Healthcare): Molina credentials each state separately. The contract request goes through the state's Molina provider site and requires an active state Medicaid enrollment; credentialing uses your CAQH ProView (DataSpring) profile.
Aetna Better Health of Texas (CVS Health): Aetna Better Health plans each have a state-specific "Join our network" request on aetnabetterhealth.com. They are separate from Aetna's commercial network, so an Aetna commercial contract does not carry over.
Blue Cross and Blue Shield of Texas (Health Care Service Corporation): This is the Blue Cross plan's Medicaid line. It is contracted separately from the plan's commercial network, so a commercial Blue Cross contract does not make you a Medicaid participant.
Texas Children's Health Plan, Community Health Choice Texas, Driscoll Children's Health Plan, Parkland Community Health Plan, Baylor Scott & White Health Plan (Scott & White Health Plan and FirstCare Health Plans), Community First Health Plans, Cook Children's Health Plan, El Paso Health, Dell Children's Health Plan: This plan is run in-state rather than by a national carrier, so participation requests go to the plan's own provider relations or contracting team, listed on its provider website.
Also in Texas: Medicare, Texas Medicaid and commercial credentialing.
Questions
Which Texas Medicaid plan is the largest?
Superior HealthPlan, with 950,499 members in 2024, 24.7% of the 3,842,754 people enrolled in Texas's Medicaid managed-care plans.
Do I have to join every Texas Medicaid plan?
No. Each plan is a separate contract. Practices usually start with the two or three largest plans in their county, then add others as patients ask for them. All of them require Texas Medicaid enrollment first.
Membership from KFF, Medicaid MCO Enrollment by Plan and Parent Firm, 2024. Plans change when the state rebids its contracts; we confirm the current list on every file.