Frequently Asked Questions

1. What doctors are in the Kelsey Plan?
When you choose a Kelsey Plan, you choose the doctors at Kelsey-Seybold to coordinate and manage your care. You can see any Kelsey-Seybold doctor at any Kelsey-Seybold location. No referrals are required to see a Kelsey-Seybold specialist in more than 65 medical specialties. Our specialists include allergists, cardiologists, dermatologists, neurologists, and oncologists – to name just a few. Should you need to see a specialist outside of Kelsey-Seybold, your doctor will refer you to an affiliate specialist. Affiliate specialists include pediatric subspecialists at Texas Children’s Hospital and Baylor College of Medicine, selected neurosurgeons, cardiovascular surgeons, and others. The collaboration among our doctors benefits you, our patient. All Kelsey-Seybold doctors and providers have access to your secure electronic medical record, so any Kelsey-Seybold healthcare provider can view your medical history, test results, and diagnostic images. This reduces duplicate testing and improves communication and quality.

2. Do I need a referral to see a Kelsey-Seybold specialist?
No referrals are required to see a Kelsey-Seybold specialist in more than 65 medical specialties. Our specialists include allergists, cardiologists, dermatologists, neurologists, and oncologists – to name just a few.

3. Do I need a referral to see a specialist outside of Kelsey-Seybold?
Should you need to see a specialist outside of Kelsey-Seybold, your doctor will refer you to an affiliate specialist. Affiliate specialists include pediatric subspecialists at Texas Children’s Hospital and Baylor College of Medicine, selected neurosurgeons, cardiovascular surgeons, and others.

4. What hospitals are available when I choose a Kelsey Plan?
Kelsey-Seybold doctors admit to hospitals in the renowned Texas Medical Center and in the community. If you need hospitalization for a surgery or other health issue, it’s good to know that Kelsey-Seybold physicians are affiliated with world-class Houston hospitals. When hospital care is needed, your doctor will determine the facility for your care. Kelsey-Seybold physicians have admitting privileges at hospitals across the Greater Houston area. This includes facilities in or near the Texas Medical Center and community hospitals stretching from The Woodlands in the north to Clear Lake and Sugar Land in the South and all points between.

Our doctors provide care at:

CHI St. Luke’s Health System Hospitals in the Texas Medical Center, Kingwood, Sugar Land, The Vintage, and The Woodlands:

• CHI St. Luke’s Health – Baylor St. Luke’s Medical Center
• CHI St. Luke’s Health – Lakeside Hospital
• CHI St. Luke’s Health – Sugar Land Hospital
• CHI St. Luke’s Health – The Vintage Hospital
• CHI St. Luke’s Health – The Woodlands Hospital

Houston Methodist Hospitals in the Texas Medical Center, Sugar Land, Katy, Willowbrook, and The Woodlands.

• Houston Methodist Texas Medical Center Hospital
• Houston Methodist Sugar Land Hospital
• Houston Methodist West Hospital
• Houston Methodist Willowbrook Hospital
• Houston Methodist The Woodlands Hospital

Memorial Hermann Hospitals in Katy and Memorial City

• Memorial Hermann Katy
• Memorial Hermann Memorial City Medical Center

HCA Houston Hospitals in Clear Lake and the Texas Medical Center

• HCA Houston Healthcare Clear Lake
• The Woman’s Hospital of Texas

Texas Children’s Hospital in the Texas Medical Center, Katy and The Woodlands

• Texas Children’s Hospital Main Campus – Texas Medical Center
• Texas Children’s Hospital West Campus – Katy
• Texas Children’s Hospital – The Woodlands

Cancer care is coordinated through the nationally accredited Kelsey-Seybold Cancer Center. Learn more at www.kelsey-seybold.com/cancercenter. MD Anderson Cancer Center and St. Luke’s Cancer Center are available by referral for complex cancer cases.

We also are affiliated with specialty hospitals, including Kindred Hospital Houston Medical Center and Cornerstone Healthcare Group. With such a wide range of facilities and locations, you can be assured if hospitalization is needed, we’re here for you!

5. What if I need outpatient care or procedures?
Many surgeries don’t require in-hospital stays. If an outpatient surgery or procedure is needed that doesn’t require an overnight hospital stay, Kelsey-Seybold offers two nationally accredited Ambulatory Surgery Centers for your care. Depending on the outpatient surgical procedure, our doctors also perform surgical procedures at our partner hospitals and affiliate outpatient surgical centers.

6. Kelsey-Seybold is in Houston. What if I become ill or injured and I’m out of the Houston area?
Emergency care, as well as urgent care at an in-network urgent care center, is a covered benefit. Emergencies are covered worldwide. Contact the phone number shown on your Member ID card for more information about in-network Urgent Care Centers outside of the Greater Houston area. After receiving care, you must notify your Kelsey-Seybold doctor as soon as possible. Please note that you have access to virtual Video Visits, available for a wide variety of conditions, on weekdays (Monday-Friday, 8 a.m.-9 p.m.) and on weekends (10 a.m.-4 p.m.). Video Visits are a great option for quality care when you’re traveling out of the area. You can contact your Kelsey-Seybold doctor’s office for help and access our After-Hours Nurse Hotline after 5 p.m. and on weekends for help. Appointments with a non-Kelsey-Seybold doctor in the doctor’s office are not covered without prior authorization from Kelsey-Seybold.

7. I have a college student attending school outside of Houston. Will my child be covered?
Yes, college students can access emergency room and in-network urgent care centers outside of Houston. They must see Kelsey-Seybold doctors for all non-emergency and routine care. College students also have access to virtual Video Visits, available for a wide variety of conditions, on weekdays (Monday-Friday, 8 a.m.-9 p.m.) and on weekends (10 a.m.-4 p.m.).