Insurance

Austin Regional Clinic is in-network for numerous insurance plans so our services can be accessible by almost everyone in the community. Below you can search the list of all participating insurance plans. ARC financial counselors are also here to help you navigate and understand your insurance coverage. Please contact 512-ARC-INFO at 512-272-4636, to get more information about our accepted health plans or doctors.

Online registration for new and established patients 

Registering in advance allows us to confirm your coverage and saves you 15-30 minutes on the day of your scheduled appointment. We offer several ways to register as a new patient or update your personal or insurance information already on file.

Accepted Insurance Plans

If you have a health plan not listed below, please expect to pay out-of-network prices based on the details in your plan. Contact your health plan for more details.

  • Commercial Plans - Coverage Through Your Job
    • 90 Degree Benefits

    • Administrative Concepts

    • Aetna

    • All Savers Alternate Funding

    • Allegeant

    • Allied Benefit Systems

    • American Medical Security

    • American Republic Insurance

    • Apwu Health Plan

    • Arm Alamo Risk Management

    • Assured Benefits Administrators

    • Bankers Life & Casualty Compan

    • Beech Street

    • Benefit Administrative Systems

    • Benefit Concepts

    • Benefit Management Administrat

    • Benefit Management, Llc

    • Benefit Plan Administrators

    • Benefit Planners

    • Blue Cross

    • Blue Essentials

    • Boon Group

    • Boon-Chapman

    • Capella Group

    • Caprock Health Plan

    • Cigna

    • Cose

    • Curative

    • Cypress Benefit Administrators

    • Decent

    • Entrust

    • Evolution Healthcare

    • First Health/Coventry

    • Freedom Life

    • Friday Health Plans

    • Geha

    • Gilsbar

    • Golden Rule

    • Great West-Cigna

    • Group Administrators

    • Healthcare Highways

    • Healthscope Benefits

    • Humana

    • Inetico, Inc

    • Insurance Benefit System Administrators

    • Insurance Tpa

    • International Benefits Administrators

    • Loomis Company

    • Mail Handlers

    • Mediview

    • Meritain Health

    • Motivhealth

    • Nippon Life Insurance

    • Pan American

    • Philadelphia American Life Ins Co

    • Physicians Mutual

    • Salvasen Health

    • Sana Benefits

    • Sbma

    • Standard Life

    • Surest (Formerly Bind)

    • Tall Tree Administrators

    • Texas Municipal League

    • Tufts Benefit Administrators

    • Umr

    • Unicare

    • United Healthcare

    • Web Tpa

  • Health Insurance Exchange (HIE) Plans
    • Aetna

    • Ambetter From Superior Health Plan

    • Blue Cross
      • BLUE ADVANTAGE HMO (BAV)

      • MYBLUE HEALTH (HMO) EFF: 1/1/2022

    • Bright Healthcare

    • Moda Health

    • Oscar

    • Sendero Health Plan

  • Medicaid
    • Automated Benefit Services-Dell-Medicaid
      • CHIP-DELL CHILDREN'S HEALTH PLAN-AUTOMATED BENEFIT SERVICES

      • DELL CHILDREN'S HEALTH PLAN-STAR-AUTOMATED BENEFIT SERVICES

    • Medicaid - Superior Health Plan

    • Medicaid - Tmhp

  • Medicare
    • Aetna
      • Aetna Medicare Premier Plan HMO (H4523-001)

      • Aetna Medicare Choice Plan PPO (H3288-004)

      • Aetna Medicare Choice I Plan PPO (H3288-046)

      • Aetna Medicare Choice II Plan PPO (H3288-048)

      • Aetna Medicare Dual Complete Plan (D-SNP) H8597-001

    • Blue Cross Advantage
      • Blue Cross Medicare Advantage Choice Plus PPO (H1666-004)

      • Blue Cross Medicare Advantage Choice Premier PPO (H1666-001)

      • Blue Cross Medicare Advantage Classic (PPO) H4801-003

      • Blue Cross Medicare Advantage Flex H4801-014(PPO)

      • Blue Cross Medicare Advantage Value (HMO) H9706-003

    • Humana Advantage
      • Humana Plus HMO ARC PCP ONLY-Medicare Advantage (H0028-037)

      • Humana Honor PPO (H5216-128)

      • Humana Choice (Regional PPO) (R4182-003)

      • Humana Choice (Regional PPO) (R4182-004)

      • Humana Choice (Regional PPO) (R4182-001)

      • Humana Choice PPO (H0473-003)

      • Humana Choice PPO (H0473-001)

      • Humana Gold Plus SNP HMO D-SNP (H0028-044)

      • Humana Honor PPO (H5216-348)

      • Humana Choice PPO (H5216-358)

    • United Healthcare
      • ​United Healthcare Medicare Advantage (PPO) H2001-817

      • United Healthcare Medicare Advantage (PPO) H2001-820

      • United Healthcare Medicare Advantage (PPO) ERS or TRS Care

    • Wellmed Medical Management
      • United Healthcare Wellmed Medicare HMO OR HMO C-SNP (H4527-039)

      • United Healthcare Medicare Silver (Regional PPO C-SNP) R6801-008

      • United Healthcare Medicare Gold (Regional PPO C-SNP) R6801-009

      • United Healthcare Medicare Dual Complete (HMO D-SNP) R6801-012

      • United Healthcare Medicare Dual Complete (HMO D-SNP) H4527-003

      • United Healthcare Medicare Dual Complete (HMO D-SNP) H4514-013

      • United Healthcare Medicare Dual Complete (HMO D-SNP) H5322-025

  • Tricare
      • TRICARE SELECT

      • TRICARE RESERVE SELECT

      • TRICARE RETIRED RESERVE

Insurance FAQs

  • What if I lost insurance due to COVID-19 or another reason?
    • You may qualify for a Special Enrollment Period to get covered through the Marketplace, Medicaid, or CHIP. If you do, you can enroll outside the yearly Open Enrollment Period. We can help you stay with your ARC doctor.
    • As a courtesy, ARC offers a 25% cash discount on most services to uninsured patients who pay in full at the time of service or by the Due Date on the first billing statement received. Please call 512-407-8686 for further details. For an estimate of charges, it is best to call your clinic in advance. Some services, such as lab tests, may be billed by the laboratory conducting testing.
  • What is the difference between in-network and out-of-network?

    There are two levels of coverage in most health plans: in-network and out-of-network. Out-of-pocket costs in both levels of coverage may include: office visit co-payments, deductibles and coinsurance.

    • In-network: This level of benefits applies when you use a physician, specialist, or other provider who is a network member. By utilizing in-network providers, you will pay lower co-payments, deductibles, and coinsurance than you will using out-of-network providers.
    • Out-of-network: This level of benefits applies when you call or see a physician, specialist, or other provider who is not a network member. You are responsible for any amounts incurred in excess of the "covered charges." "Covered charges" are pre-determined usual, customary and reasonable charges for a particular service. You must call your health plan to learn more about your covered charges.
  • What is my co-pay?

    The co-pay amount is usually listed on your insurance card. If it is not there you will need to call your insurance company to find out your co-pay amount.

  • What is a PCP?

    PCP stands for Primary Care Physician. This would be the physician that you see on a regular basis.

  • What is a guarantor VS subscriber?
    • A guarantor is the adult financially responsible for a patient’s account after insurance payments have been made. The guarantor is usually the patient unless the patient is a minor or otherwise incapacitated adult.
    • A subscriber is the main person enrolled in the insurance plan often times through an employer and may also be referred to as the primary insured.
  • Does ARC accept Medicare and Medicare Advantage plans?

    ARC accepts traditional Medicare and several Medicare Advantage Plans. We welcome new and established patients with these plans to ARC and encourage all patients to learn about their Medicare options.

    All Medicare Advantage plans accepted at ARC include the Connected Senior Care Advantage (CSCA) program, proactively coordinating healthcare for members and offering additional wellness benefits like dental, hearing, and vision coverage. View your Medicare options at ARC.

  • How can I get help choosing the right Medicare plan?
  • How do I update my insurance information?

    ARC offers you a few different ways to update your insurance information.

  • How can I get help choosing the right Healthcare Insurance Exchange plan?

    Visit ProsperHealthCoverage.org or call 512-381-4520 for help finding affordable health insurance that meets your health care needs and budget. Prosper Health Coverage is a free service available to individuals and families in Texas regardless of income level.