What Insurance Does MD Anderson Accept In-Network?

MD Anderson Cancer Center accepts most major commercial insurance plans, Original Medicare, and select Medicare Advantage, Medicaid, VA, and TRICARE arrangements, but it does not participate in individual ACA Marketplace plans and network status can vary by employer group even within the same insurer. The only reliable way to confirm what insurance MD Anderson accepts for your specific policy is to call the number on the back of your insurance card and verify that MD Anderson is in your plan’s network. MD Anderson’s insurance support line at 1-888-723-4046 can also help you sort through coverage questions before your first appointment.¹

Commercial Insurers In-Network at MD Anderson

As of mid-2025, MD Anderson contracts with a range of private insurers across multiple product types. The published list includes Aetna (HMO, PPO, POS, and indemnity), Blue Cross Blue Shield of Texas (HMO, PPO, POS, and indemnity), Cigna Healthcare (HMO, PPO, POS, and indemnity), and UnitedHealthcare through its Cancer Resource Services/OptumHealth program. Smaller networks like First Health, Beech Street, and Memorial Hermann Health PPO also appear on the list. For stem cell transplants and CAR-T therapy, MD Anderson participates in transplant-specific programs including Blue Distinction Centers, Cigna LifeSource, and OptumHealth Centers of Excellence.¹

Being on that list doesn’t guarantee your policy is covered. Network access for several of the plans varies by employer group, meaning your specific employer’s contract determines whether MD Anderson qualifies as in-network for you. Some benefit plans also use what MD Anderson describes as “narrow” or “limited” networks that further restrict which hospitals and doctors you can see.¹

Plan type also affects your out-of-pocket cost. PPOs generally allow out-of-network care at a higher cost share, so a PPO may still reimburse a portion of the bill even if MD Anderson isn’t preferred. HMOs rarely cover anything outside their network without a specific referral or authorization. Some insurers use tiered networks in which MD Anderson sits in a higher-cost tier, meaning higher copayments or coinsurance even when technically in-network. Review your Summary of Benefits and Coverage carefully, because the difference between Tier 1 and Tier 2 can mean thousands of dollars over the course of cancer treatment.

ACA Marketplace Plans Are Excluded

This is where many patients get blindsided. MD Anderson is not a participating provider for individual ACA Marketplace plans from any of the major insurers. The exclusions specifically include Aetna/CVS ACA individual plans, all ACA individual BCBS plans in Texas (including Blue Advantage HMO and Blue Advantage Plus HMO), Cigna ACA individual plans (including Cigna Connect and Cigna Plus), and UnitedHealthcare ACA individual plans.¹

If you bought your health insurance through Healthcare.gov or a state exchange, assume MD Anderson is out of network unless you’ve confirmed otherwise. Being out of network doesn’t stop you from receiving treatment, but it changes the cost picture significantly.

Medicare and Medicare Advantage

MD Anderson accepts Medicare, but how much you pay depends on which version of Medicare you have. Original Medicare (Parts A and B) has no provider network, so you can be treated at any facility that accepts Medicare assignment. Part A covers inpatient hospital stays, and Part B covers outpatient services such as doctor visits, imaging, and chemotherapy infusions. Part D covers prescription drugs, including oral cancer medications, though your plan’s formulary determines which drugs are covered and at what cost-sharing level.²

Medicare Advantage (Part C) is different. These private plans replace Original Medicare and almost always impose network restrictions. An HMO-style Medicare Advantage plan may not include MD Anderson at all, and even PPO-style Advantage plans charge significantly more for out-of-network care. MD Anderson does participate in some Medicare Advantage PPO products, including Blue Cross Blue Shield of Texas Medicare Advantage PPO plans like UT CARE and the Kelsey Care Advantage plan, which requires a referral from Kelsey-Seybold.¹

Medicare Advantage plans also require prior authorization for most cancer services, including imaging, radiation therapy, chemotherapy, and hospital stays. If you’re weighing a Medicare Advantage plan and may need specialized cancer care, look carefully at the plan’s provider directory and prior authorization rules before enrolling. Switching back to Original Medicare is possible during certain enrollment periods, though the timing doesn’t always line up with a new diagnosis.

Medicaid, VA, and TRICARE

Medicaid coverage at MD Anderson is limited. The center participates with Texas Children’s Health Plan for Medicaid and CHIP beneficiaries, but it may not be in-network for all Medicaid managed care organizations.¹ Medicaid patients enrolled in a managed care plan should check their provider directory and authorization policies. Coverage for experimental treatments and clinical trials under Medicaid can also be more restrictive than under private insurance or Medicare.

Veterans enrolled in VA health care generally receive treatment at VA facilities first. The VA can authorize care at outside providers through the Community Care Network if the VA can’t provide the needed service, wait times exceed access standards, or other qualifying criteria are met.³ A community care referral to MD Anderson requires your VA health care team’s approval, and you must obtain the referral before scheduling an appointment.⁴

TRICARE rules differ sharply between Prime and Select. TRICARE Prime enrollees need a referral from their primary care manager and pre-authorization for all specialty care, including oncology. TRICARE Select beneficiaries do not need a referral for specialty care, with narrow exceptions, which gives them more flexibility to seek treatment at MD Anderson directly.⁵ Under either plan, confirm that MD Anderson is a TRICARE-authorized provider in your region and verify cost-sharing before starting treatment.

Employer Plan Wrinkles

Coverage through an employer plan follows the same insurer network rules described above, but employers have additional levers that affect your access. Large employers often run self-funded plans where the company itself pays claims and hires an insurer just to handle paperwork. The name on your card might be Aetna or Cigna, but your employer’s specific contract dictates whether MD Anderson is in your network. Smaller employers typically buy fully insured plans where the insurer controls the network directly.

Some large employers and unions have gone further by designating MD Anderson as a Center of Excellence for cancer treatment. Under these arrangements, employees with qualifying diagnoses get in-network benefits at MD Anderson regardless of standard network rules, and some programs cover travel and lodging expenses. These programs generally require pre-approval, so check with your HR department or benefits administrator if you think your employer may participate.

If you leave a job during treatment, COBRA lets you continue your employer’s group health plan for up to 18 months, and certain qualifying events like disability or divorce can extend that to 36 months.⁶ The critical advantage for a patient mid-treatment is that your deductible progress carries over, so you don’t restart at zero the way you would with a new Marketplace plan. The tradeoff is that you pay the full premium yourself, plus up to a 2% administrative fee, with no employer subsidy.

If MD Anderson Is Out of Network

An out-of-network status isn’t the end of the road. You’ll pay more and you’ll need to plan ahead, but options exist.

Gap Exception or Single Case Agreement

Many insurers allow a gap exception or single case agreement when an in-network provider can’t offer the specialized care you need. A single case agreement is a one-time arrangement between your insurer and MD Anderson to cover your treatment at in-network rates. Insurers are more likely to approve these when no comparable in-network cancer center can provide the needed service, such as a specific type of surgery, a rare cancer subspecialty, or access to a particular clinical trial. Ask your insurer about this option before assuming you’re stuck with full out-of-network costs.

Out-of-Network Deposits

If your insurance is not accepted or you’re paying on your own, MD Anderson requires a deposit before your first appointment. The deposit is an estimate, and your actual charges may be higher or lower depending on the services you receive.⁷ Contact MD Anderson’s financial services department to request a pre-treatment cost estimate so you know what to expect.

What the No Surprises Act Does and Doesn’t Cover

The federal No Surprises Act, in effect since 2022, bans surprise bills for emergency services even when you receive care from an out-of-network provider. It also limits cost-sharing for certain out-of-network services provided at an in-network facility, such as when an out-of-network anesthesiologist or pathologist treats you during an in-network hospital stay. These protections apply to employer-sponsored plans (including self-funded ERISA plans) and individual market plans.⁸

The Act does not turn an out-of-network facility into an in-network one for planned, non-emergency treatment. If you choose to go to MD Anderson knowing it’s out of network, the facility can ask you to sign a consent form acknowledging the higher costs. The protection is against bills you didn’t see coming, not the cost consequences of a deliberate choice.

Financial Assistance for Uninsured or Underinsured Patients

Patients without insurance or with inadequate coverage may qualify for MD Anderson’s Patient Financial Assistance program. The program is designed for Texas residents who have no other means to pay for care. To be eligible, you must have been a Texas resident for at least six months.⁹

Eligibility is based on your yearly income plus 25% of the value of your assets, excluding your home and vehicles. If that combined figure falls at or below 400% of the federal poverty level for your family size, you may qualify for up to 100% aid covering hospital charges, clinic charges, doctor’s fees, and prescriptions. For 2026, the federal poverty level is $15,960 for a single person and $33,000 for a family of four, which puts 400% at roughly $63,840 and $132,000 respectively.⁹¹⁰ Aid approval lasts up to one year and requires annual reapplication.

Even if you don’t qualify for full financial assistance, ask about payment plans and discounted self-pay rates. MD Anderson’s financial counselors can walk you through the options before treatment begins, which is always better than trying to negotiate after bills start arriving.

1
UT MD Anderson. Insurance Plans
2
USAGov. How and When to Apply for Medicare
3
Veterans Affairs. Eligibility for Community Care Outside VA
4
U.S. Department of Veterans Affairs. How to Get Community Care Referrals and Schedule Appointments
5
TRICARE. Referrals and Pre-Authorizations
6
U.S. Department of Labor. FAQs on COBRA Continuation Health Coverage for Workers
7
UT MD Anderson Cancer Center. Insurance, Billing and Financial Support
8
U.S. Department of Labor. Avoid Surprise Healthcare Expenses: How the No Surprises Act Can Protect You
9
MD Anderson Cancer Center. Patient Financial Assistance Overview
10
HHS ASPE. 2026 Poverty Guidelines