Sheldon Gaines, MD

KelseyCare Aetna

Aetna PPO, POS, and EPO Plans

Kelsey-Seybold Clinic is an in-network provider for most Aetna PPO, POS, and EPO plans*, including:

• Aetna Select
• Open Access Select
• Elect Choice
• Aetna Open Access Elect Choice
• Aetna Choice POS II
• Managed Choice
• Open Choice PPO
• Aetna Medicare Advantage Plans

Aetna CVS Health Marketplace Plans (HMO)

A Kelsey-Seybold PCP is required to schedule a primary care appointment. Please contact Aetna at the phone number on the back of your member ID card, or go online to the Aetna CVS member portal to change to a Kelsey-Seybold PCP prior to your appointment.

Kelsey-Seybold Clinic is in network with all Houston-area Aetna CVS Health Individual and Family Plans on the ACA Marketplace effective January 1, 2025:

• Silver 2
• Silver 5
• Silver 10
• Silver S
• Gold 3
• Gold 4
• Gold 10
• Gold S

*All Houston area Aetna CVS Health plans are accepted at Kelsey-Seybold Clinic*

*Aetna Marketplace members who have a Memorial Hermann Medical Group physician listed as their PCP do not have access to Kelsey-Seybold. If you would like access to Kelsey-Seybold Clinic services, please contact Aetna and change your PCP to a Kelsey-Seybold Clinic provider.

*Kelsey-Seybold does not participate in any commercial Aetna HMO and HNO plans, including Aetna QPOS.

Blue Cross Blue Shield

The specific BCBSTX PPO and HMO plans in which Kelsey-Seybold participates are:

• Anthem BCBS PPO
• Blue Access Choice PPO
• Blue Access PPO
• Blue Card PPO
• Blue Edge PPO
• Blue Essentials HMO Click here to learn more about selecting a Kelsey Primary Care Physician
• Blue Choice PPO
• Blue Cross Blue Shield of Texas
• Blue Cross Blue Shield Federal Employee Program (Basic and Standard Option)
• Coupe Health plan
• Health Select of Texas - ERS Click here to learn more about selecting a Kelsey Primary Care Physician
• TRS-ActiveCare Primary Click here to learn more about selecting a Kelsey Primary Care Physician
• TRS-ActiveCare Primary+ Click here to learn more about selecting a Kelsey Primary Care Physician
• TRS-ActiveCare HD
• TRS-ActiveCare 2
• UT Select

Kelsey-Seybold does not participate in the following BCBSTX plans: Blue Premier, Blue High-Performance network, Marketplace plans: My Blue Health, and Blue Advantage HMO, or any BCBSTX Medicare products.

Cigna

• Choice Fund PPO
• Choice Fund Open Access Plus (OAP)
• Cigna EPO
• Cigna HMO
  • Note: A Kelsey-Seybold PCP is required to schedule a primary care appointment. Please contact Cigna at the phone number on the back of your member ID card or go online to the Cigna member portal to select a Kelsey-Seybold PCP prior to your appointment.
• Cigna KelseyCare
• Cigna HMO Open Access (OA)
• Cigna HMO Open Access Plus (OAP)
• Cigna POS
• Cigna PPO
• Cigna Consumer Driven Health Plan (CDHP)
• Cigna Surefit
  • Note: A Kelsey-Seybold PCP is required to schedule a primary care appointment. Please contact Cigna at the phone number on the back of your member ID card or go online to the Cigna member portal to select a Kelsey-Seybold PCP prior to your appointment.
• KelseyCare powered by Cigna
• LocalPlus
• LocalPlus IN

Kelsey Plan

When you select a Kelsey Plan, you’re choosing the doctors at Kelsey-Seybold Clinic to deliver and coordinate your care. Learn more here.

KelseyCare Advantage

More Information

KelseyCare Aetna

Kelsey-Seybold does not participate in Aetna HMO and HNO plans, including Aetna QPOS.  

KelseyCare Powered by Cigna

HMO

Aetna Medicare

KelseyCare Advantage

Wellcare / TexanPlus

United HealthCare

Allied Benefit Systems/NGBS

Federal Employee Health Benefits (FEHB) 

• APWU Health Plan Nationwide – CDHP with UnitedHealthcare PPO
• APWU Health Plan Nationwide – High Option with Cigna PPO
• GEHA Benefit Plan Nationwide – High & Standard Options with UnitedHealthcare Choice Plus
• NALC Nationwide with Cigna OAP
• NALC Value Option Nationwide with Cigna OAP
• SAMBA Nationwide – High & Standard with Cigna OAP
• Blue Cross Blue Shield – Standard Option
• Blue Cross Blue Shield – Basic Option

First Health PPO

Great West Healthcare (also known as Cigna-GWH)

• POS
• PPO
• Open Access

HealthSmart PPO

Medicare

Kelsey-Seybold Clinic accepts the following Medicare Advantage Plans: KelseyCare Advantage, Aetna Medicare Advantage, WellCare TexanPlus, and select UnitedHealthcare plans. Effective January 1, 2009, Kelsey-Seybold Clinic does not accept patients with traditional Medicare.

MultiPlan PPO

Private Healthcare Systems PPO (PHCS) 

UnitedHealthcare (UHC) Individual & Family Plans

• UHC Kelsey-Seybold Bronze Copay Focus
• UHC Kelsey-Seybold Bronze-A Copay Focus
• UHC Kelsey-Seybold Bronze-B Copay Focus
• UHC Kelsey-Seybold Bronze-X Copay Focus
• UHC Kelsey-Seybold Silver Copay Focus
• UHC Kelsey-Seybold Silver-E Copay Focus
• UHC Kelsey-Seybold Silver-D Copay Focus
• UHC Kelsey-Seybold Silver-C Copay Focus
• UHC Kelsey-Seybold Silver-A Copay Focus
• UHC Kelsey-Seybold Silver-B Copay Focus
• UHC Kelsey-Seybold Silver-X Copay Focus
• UHC Kelsey-Seybold Gold Copay Focus
• UHC Kelsey-Seybold Gold-A Copay Focus
• UHC Kelsey-Seybold Gold-B Copay Focus
• UHC Kelsey-Seybold Gold-X Copay Focus

UnitedHealthcare (UHC)

• UnitedHealthcare Charter
  • Note: A Kelsey-Seybold PCP is required to schedule a primary care appointment. Please contact United Healthcare Charter at the phone number on the back of your member ID card or go online to the United Healthcare member portal to select a Kelsey-Seybold PCP prior to your appointment.
• UnitedHealthcare Choice
• UnitedHealthcare Choice Plus
• UnitedHealthcare Core
• UnitedHealthcare Core Plus
• UnitedHealthcare Navigate
  • Note: A Kelsey-Seybold PCP is required to schedule a primary care appointment. Please contact United Healthcare Navigate at the phone number on the back of your member ID card or go online to the United Healthcare member portal to select a Kelsey-Seybold PCP prior to your appointment.
• UnitedHealthcare Navigate Plus
  • Note: A Kelsey-Seybold PCP is required to schedule a primary care appointment. Please contact United Healthcare Navigate Plus at the phone number on the back of your member ID card or go online to the United Healthcare member portal to select a Kelsey-Seybold PCP prior to your appointment.
• UnitedHealthcare NexusACO-R
  • Note: A Kelsey-Seybold PCP is required to schedule a primary care appointment. Please contact United Healthcare NexusACO at the phone number on the back of your member ID card or go online to the United Healthcare member portal to select a Kelsey-Seybold PCP prior to your appointment.
• UnitedHealthcare NexusACO (OAP and OA)
• UnitedHealthcare Options PPO
• UnitedHealthcare Select
• UnitedHealthcare Select Plus
• United Healthcare Surest plan

UnitedHealthcare (UHC) Medicare Advantage Plans