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Know your Medicare options

Check availability by service coverage area.

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COVID-19: What you need to know about the outbreak of the coronavirus

We care about the health and well-being of all of our members. As we continue to monitor the spread of COVID-19, we are committed to keeping you informed. Click here for more information.

For Medicare Advantage members, effective March 6, 2020, and until further notice:

Scott and White Health Plan is waiving member cost-sharing for care related to COVID-19, which includes testing, telehealth services, outpatient office visits and inpatient hospital stays.

URGENT: Hurricane Hanna Assistance

We're here to help! Due to the effects of Hurricane Hanna, impacted members are encouraged to visit swhp.org/disaster for updates & information. Contact Customer Service for assistance accessing medical care and/or services.

Network Update for the Waco Area

The Ascension Providence health system has extended its contract with Scott and White Health Plan through December 31, 2020.

New! Enable Mobile SMS Text Notifications in Member Portal Message Center

You may opt-in for SMS Text Notifications service by updating your preferences in the Member Portal. These steps show you how.

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Plan Year 2020 — Enrollment

Select Your County of Residence

Service coverage area eligibility is, by law, based on your county of residence. We offer one or more plans for the following Texas counties:

Don't see your Texas County? Other Texas counties are outside our 2020 service coverage areas.

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Recently Applied Online? 

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SeniorCare Advantage HMO Plan Members

Member Quicklinks

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SeniorCare Advantage PPO Plan Members

Member Quicklinks

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Medicare coverage the way it should be

Enroll Now

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As a Medicare member, you have the right to:

  • • Ask for coverage of a medical service or prescription drug. In some cases, we may allow exceptions for a service or drug that is normally not covered.
  • • File an appeal if your request is denied. An appeal is a formal way of asking us to review and change a coverage decision we made.

You can submit your request for medical service coverage or appeal to the following:

  • Mail:
  • Scott and White Health Plan
  • 1206 West Campus Drive
  • Temple, TX 76502
  • Fax: 1-800-626-3042
  • Phone: 1-866-334-3141 (TTY 711)

You can submit your request for Part D drug coverage or redetermination (appeal) as follows:

Coverage determinations

  • Mail:
 
  • OptumRx
  • Attn: Prior Auth Exceptions
  • P.O. Box 25183
  • Santa Ana, CA 92799

Redetermination (appeal)

  • Mail:
 
  • OptumRx
  • Prior Authorization Department
  • c/o Appeals Coordinator
  • P.O. Box 25184
  • Santa Ana, CA 92799

* Standard Medicare Part D redetermination (appeal) requests must be submitted in writing and cannot be initiated via phone. If you believe waiting 7 days for a standard Medicare Part D redetermination decision could seriously harm the member's life, health, or ability to regain maximum function, you can ask for an expedited decision; expedited Medicare Part D redetermination requests can be initiated via phone.

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ATTENTION: If you speak Spanish, language assistance services, free of charge, are available to you. Call 1-866-334-3141 (TTY: 711).

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