For Members

We value our members on all of all plans and we want to make sure that you are receiving the best care possible. Our team is here to help you with the following:

  • Providing the information you need about your plan to make your care as smooth as possible
  • Providing the information you need about your health and wellbeing to prevent getting sick
  • Answering any questions you may have about your plan and the care you have received

Please use the Table of Contents on this page for information specific to the plan you are looking for.

About Seton Health Plan

Seton Health Plan (SHP) is an HMO health plan licensed by the Texas Department of Insurance (TDI). In addition to the HMO license, SHP has a Utilization Review Agent license, which focuses on the utilization management/medical management components of health plans and on improving the overall quality of health plans.

SHP currently serves the Medicaid STAR (18,000 members), Children’s Health Insurance Program (CHIP) (8,700 members), Seton Employee Benefit Plan (22,000 lives) and MAP/charity/sliding fee scale (35,000 lives) populations.

SHP began as a health plan in 1999 by serving the CHIP population. In 2002, SHP began serving the MAP population, and in 2003, it began administering the Seton Employee Benefit Plan known as SmartHealth. In 2012, SHP expanded into Medicaid with the addition of the STAR product. The plan is wholly owned affiliate of the Seton Healthcare Family.