During the open enrollment period for the federal health insurance marketplace, Central Health and Sendero Health Plans, the health district’s nonprofit health maintenance organization, are expanding a program that provides for health insurance premiums for Travis County residents with chronic illnesses and complex medical needs.

Central Health announced the expansion in an Oct. 30 news release ahead of open enrollment, which runs Nov. 1-Dec. 15. The Central Health program pays insurance premiums for chronically ill patients who meet certain health care criteria and are enrolled in the Medical Access Program, Central Health’s health insurance coverage for low income residents, according to the news release.

The Medical Access Program provides health coverage for local residents living at or below 100% of the Federal Poverty Level who are not eligible for other coverage programs, including Medicaid and the Children’s Health Insurance Program, or enrolled with private insurance, according to the news release. Earlier this year, Central Health expanded its program with Medical Access Program BASIC, which enrolls residents with higher incomes.

The coverage plan utilizes federal funds from the Affordable Care Act’s risk adjustment program, a move that was authorized in September of last year by the Central Health Board of Managers, according to the health care district. The news release states the program funded 500 Medical Access Program enrollees with complex medical needs.

Of the 500 eligible Medical Access Program members, more than 200 chose to enroll in Sendero’s IdealCare health plan, Central Health stated.


IdealCare is a private health plan that offers a broader range of providers than other government health care coverage plans.

“This year we hope to double the number of patients who choose to transition from [the Medical Access Program] to Sendero, and we realize that will take an intensive outreach strategy to help patients understand their options and make the choice that is best for them,” said Dr. Guadalupe Zamora, board chair of Central Health, in the Oct. 30 news release.

Central Health accounted for $7 million in ACA High Risk Premium subsidies for its fiscal year 2020, according to budget documents.

The health care district’s Oct. 30 news release states that budget allotment is set to enroll between 300-350 current Medical Access Program and MAP BASIC members in Sendero.