Texas Plan Benefit Materials

 

This booklet gives you a summary of costs and coverage in your plan. Please select the document for your plan and county:

For HMO Members:

Plan Name CMS # County Summary of Benefits
Ascension Complete Seton Reward (HMO) H6678-001 Bastrop, Burnet, Hays, Travis, Williamson
Ascension Complete Seton Secure (HMO) H6678-002 Bastrop, Burnet, Hays, Travis, Williamson
Ascension Complete Providence Reward (HMO) H6678-003 Bell, McLennan
Ascension Complete Providence Secure (HMO) H6678-004 Bell, McLennan

For PPO Members:

Plan Name CMS # County Summary of Benefits
Ascension Complete Seton Access Plus (PPO) H9357- 001 Bastrop, Burnet, Hays, Travis, Williamson
Ascension Complete Seton Access (PPO) H9357- 002 Bastrop, Burnet, Hays, Travis, Williamson
Ascension Complete Providence Access Plus (PPO) H9357- 003 Bell, McLennan
Ascension Complete Providence Access (PPO) H9357- 004 Bell, McLennan

This booklet gives you a complete list of services, limitations and exclusions for your plan coverage. Please select the document for your plan and county:

For HMO Members:

Plan Name CMS # County Evidence of Coverage
Ascension Complete Seton Reward (HMO) H6678-001 Bastrop, Burnet, Hays, Travis, Williamson
 
Ascension Complete Seton Secure (HMO) H6678-002 Bastrop, Burnet, Hays, Travis, Williamson
 
Ascension Complete Providence Reward (HMO) H6678-003 Bell, McLennan
 
Ascension Complete Providence Secure (HMO) H6678-004 Bell, McLennan
 

For PPO Members:

Plan Name CMS # County Evidence of Coverage
Ascension Complete Seton Access Plus (PPO) H9357- 001 Bastrop, Burnet, Hays, Travis, Williamson
Ascension Complete Seton Access (PPO) H9357- 002 Bastrop, Burnet, Hays, Travis, Williamson
 
Ascension Complete Providence Access Plus (PPO) H9357- 003 Bell, McLennan
Ascension Complete Providence Access (PPO) H9357- 004 Bell, McLennan
 

 

If you have any questions please, contact Member Services.