Do you qualify for Texas STAR (Medicaid)?
Thinking about becoming a 桃子视频 Member? Here is some useful information about the Medicaid Program and 桃子视频 to get you started.
Thinking about becoming a 桃子视频 Member? Here is some useful information about the Medicaid Program and 桃子视频 to get you started.
Thinking about becoming a 桃子视频 Member? Here is some useful information about the Medicaid Program and 桃子视频 to get you started.
CHIP and Medicaid automatic benefit renewal has ended.
Visit our听public health emergency site听for more information.
Read about our End of Continuous Medicaid Coverage FAQ 30-Day Extension
桃子视频 provides both Children鈥檚 Medicaid and Medicaid for Pregnant Women. These programs are provided at no cost to U.S. residents who cannot afford health insurance.
Children’s Medicaid – Children鈥檚 Medicaid covers a child up through the month of his or her 21st birthday. Income determines eligibility. That income level is different based on age and Medicaid program. Members must recertify every year.
Medicaid for Pregnant Women – Medicaid for Pregnant Women covers a childbearing woman of any age. Members must be at 185% or lower of the Federal Poverty Level (FPL). Members must recertify every year.
桃子视频 is a managed care organization that offers Texas Medicaid STAR coverage and provides services that are covered benefits of the Medicaid Program.
Read the Benefits section of our Member handbook to see what is covered, what is not covered, and how to get these benefits, and what to do in an emergency or crisis situation.
Moral or Religious Objections
桃子视频 does not exclude access to any services because of moral or religious objections.
Medicaid does not provide coverage if you are out of the country. Benefit coverage is limited to your service area. If you are outside of our service area, benefits are limited to emergency care.
Read about our service area coverage in our STAR Handbook.
For a list of covered services listed, view the Member Handbook.
For a list of exclusions view the Member Handbook.
After a person chooses a managed care organization, like 桃子视频, to provide their healthcare, they then choose a Primary Care Provider to give them all their primary care services. This includes coordinating referrals for all medically necessary specialty services. Want to see if your Provider, specialist or hospital is in our network? . |
桃子视频 follows the Texas Vendor Drug Formulary for Medicaid and CHIP. Updates to the formulary are managed by the Texas Vendor Drug Program.
Here is how to search:
This search will tell you:
Drugs are listed as 鈥減referred鈥� and 鈥渘on-preferred.鈥� If you need a 鈥渘on-preferred鈥� drug, your doctor will need to submit a special request to get the 鈥渘on-preferred鈥� drug by calling Member Services toll-free at 1.888.760.2600.
Our Notice of Privacy Practices is given to you as part of the Health Insurance Portability and Accountability Act (HIPAA). It says how we can use or share your protected health information (PHI) and sensitive personal information (SPI). We review this notice annually and update if needed.
鈥淧rotected health information鈥� and 鈥渟ensitive personal information鈥� (PHI/SPI) is information that identifies a person or patient. These data can can be your age, address, e-mail address, and medical facts. It can be about your past, present or future physical or mental health conditions. It also can be about sensitive healthcare services and other personal facts.
It tells you who we can share it with and how we keep it safe. This includes protection of your oral, written and electronic information across the organization. It tells you how to get a copy of or edit your information. It ensures that any oral, written, and electronic information you share with us is confidential and secure.
You can allow or not allow us to share specific details unless needed by law. You have the right to approve or withdraw the use of your information.
Read our full Privacy Notice section in our Member Handbook.
Lost your Medicaid benefits? The Healthy Texas Women Program provides family planning exams, related health assessments, and birth control to women ages 18 to 44 whose family income is at or below the program鈥檚 income limits (185 percent of the Federal Poverty Level).
You must apply to find out if you can receive services through this program. Visit the for more information.
Autism Spectrum Disorder (ASD) is a developmental disorder that affects communication and behavior. It is characterized by restricted, repetitive patterns of behavior, interests, or activities and deficits in social communication and social interaction, with onset of symptoms occurring in early childhood.
Effective February 1, 2022, Autism Services, to include Applied Behavior Analysis (ABA) evaluation and treatment, became a benefit of the Texas Health Steps-Comprehensive Care Program (THSteps-CCP) for Texas Medicaid recipients who are 20 years of age and younger and who meet the criteria outlined in the Autism Services benefit description. This benefit is not available for CHIP recipients.
Medicaid Applied Behavior Analysis (ABA) Services for Children and Youth With Autism
ABA is one of many services available for Medicaid members, age 20 or younger, who have a diagnosis of autism spectrum disorder (ASD). ABA is a treatment approach provided by specialists called licensed behavior analysts (LBAs).
If your child is eligible, ABA can help:
Click here for more Applied Behavioral Analysis Services information.
Yes, prior authorization is required for evaluation and treatment. A great place to start is your child鈥檚 Primary Care Provider (PCP). They may recommend a Provider that meets your child鈥檚 needs. A signed referral must be submitted to the ABA Provider to accompany their Authorization request.
Your child can be evaluated by any of the following health care providers.
To find a provider, visit 听or call Member Services at 713.295.2294 or toll free at 1.888.760.2600.
Need help finding and getting services? You might be able to get a case manager to help you.
Children, teens, young adults (birth through age 20) and pregnant women who get Medicaid and:
A case manager will visit with you and then:
Case managers can help you:
Contact 桃子视频 for more information Monday to Friday, 8 a.m. to 6 p.m. or call Texas Health Steps at 1-877-847-8377 (toll-free), Monday to Friday, 8 a.m. to 8 p.m.
Filing a Complaint: If you get health insurance benefits through 桃子视频 STAR Program, call your medical or dental plan first. If you don鈥檛 get the help you need there, you should do one of the following:
General Information
Local: 713.295.2222
Toll-Free: 1.877.635.6736
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 6:00 p.m
Member Services
Local: 713.295.2294 | Toll-Free: 1.888.760.2600
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 6:00 p.m.
Provider Services Hotline
Call 713.295.2295, 8:00 a.m. – 5:00 p.m., Monday 鈥� Friday
桃子视频 provides both Children鈥檚 Medicaid and Medicaid for Pregnant Women. These programs are provided at no cost to U.S. residents who cannot afford health insurance.
Children鈥檚 Medicaid 鈥� Children鈥檚 Medicaid covers a child up through the month of his or her 21st birthday. Income determines eligibility. That income level is different based on age and Medicaid program. Members must recertify every year.
Medicaid for Pregnant Women 鈥撎�Medicaid for Pregnant Women covers a childbearing woman of any age. Members must be at 185% or lower of the Federal Poverty Level (FPL). Members must recertify every year.
桃子视频 is a managed care organization that offers Texas Medicaid STAR coverage and provides services that are covered benefits of the Medicaid Program.
Read the Benefits section of our Member handbook to see what is covered, what is not covered, and how to get these benefits.
Moral or Religious Objections
桃子视频 does not exclude access to any services because of moral or religious objections.
Medicaid does not provide coverage if you are out of the country. Benefit coverage is limited to your service area. If you are outside of our service area, benefits are limited to emergency care.
Read about our service area coverage in our STAR Handbook.
For a list of covered services listed, view the Member Handbook.
For a list of exclusions view the Member Handbook.
After a person chooses a managed care organization, like 桃子视频, to provide their healthcare, they then choose a Primary Care Provider to give them all their primary care services. This includes coordinating referrals for all medically necessary specialty services.
Want to see if your Provider, specialist or hospital is in our network?听.
桃子视频 follows the Texas Vendor Drug Formulary for Medicaid and CHIP. Updates to the formulary are managed by the Texas Vendor Drug Program.
Here is how to search:
This search will tell you:
Drugs are listed as 鈥減referred鈥� and 鈥渘on-preferred.鈥� If you need a 鈥渘on-preferred鈥� drug, your doctor will need to submit a special request to get the 鈥渘on-preferred鈥� drug by calling Member Services toll-free at 1.888.760.2600.
Some benefits and services must be reviewed and approved by our Utilization Management Department. Here are some things you should know about utilization management services.
Our Notice of Privacy Practices is given to you as part of the Health Insurance Portability and Accountability Act (HIPAA). It says how we can use or share your protected health information (PHI) and sensitive personal information (SPI). We review this notice annually and update if needed.
鈥淧rotected health information鈥� and 鈥渟ensitive personal information鈥� (PHI/SPI) is information that identifies a person or patient. These data can can be your age, address, e-mail address, and medical facts. It can be about your past, present or future physical or mental health conditions. It also can be about sensitive healthcare services and other personal facts.
It tells you who we can share it with and how we keep it safe. This includes protection of your oral, written and electronic information across the organization. It tells you how to get a copy of or edit your information. It ensures that any oral, written, and electronic information you share with us is confidential and secure.
You can allow or not allow us to share specific details unless needed by law. You have the right to approve or withdraw the use of your information.
Read our full Privacy Notice section in our Member Handbook.
Lost your Medicaid benefits? The Healthy Texas Women Program provides family planning exams, related health assessments, and birth control to women ages 18 to 44 whose family income is at or below the program鈥檚 income limits (185 percent of the Federal Poverty Level).
You must apply to find out if you can receive services through this program. Visit the听听for more information.
Autism Spectrum Disorder (ASD) is a developmental disorder that affects communication and behavior. It is characterized by restricted, repetitive patterns of behavior, interests, or activities and deficits in social communication and social interaction, with onset of symptoms occurring in early childhood.
Effective February 1, 2022, Autism Services, to include Applied Behavior Analysis (ABA) evaluation and treatment, became a benefit of the Texas Health Steps-Comprehensive Care Program (THSteps-CCP) for Texas Medicaid recipients who are 20 years of age and younger and who meet the criteria outlined in the Autism Services benefit description. This benefit is not available for CHIP recipients.
Medicaid Applied Behavior Analysis (ABA) Services for Children and Youth With Autism
ABA is one of many services available for Medicaid members, age 20 or younger, who have a diagnosis of autism spectrum disorder (ASD). ABA is a treatment approach provided by specialists called licensed behavior analysts (LBAs).
If your child is eligible, ABA can help:
Click here for more听Applied Behavioral Analysis Services听information.
Yes, prior authorization is required for evaluation and treatment. A great place to start is your child鈥檚 Primary Care Provider (PCP). They may recommend a Provider that meets your child鈥檚 needs. A signed referral must be submitted to the ABA Provider to accompany their Authorization request.
Your child can be evaluated by any of the following health care providers.
To find a provider, visit听听or call Member Services at 713.295.2294 or toll free at 1.888.760.2600.
Need help finding and getting services? You might be able to get a case manager to help you.
Contact 桃子视频 for more information Monday to Friday, 8 a.m. to 6 p.m. or call Texas Health Steps at 1-877-847-8377 (toll-free), Monday to Friday, 8 a.m. to 8 p.m.
Filing a Complaint: If you get health insurance benefits through 桃子视频 STAR Program, call your medical or dental plan first. If you don鈥檛 get the help you need there, you should do one of the following:
General Information
Local: 713.295.2222
Toll-Free: 1.877.635.6736
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 6:00 p.m
Member Services
Local: 713.295.2294 | Toll-Free: 1.888.760.2600
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 6:00 p.m.
Provider Services Hotline
Call 713.295.2295, 8:00 a.m. – 5:00 p.m., Monday 鈥� Friday
As a local nonprofit health plan, 桃子视频 gives you plenty of reasons to join our 桃子视频. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, 桃子视频 is always working life forward for you and your family.
鈥溙易邮悠� is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.鈥�
鈥� Cecily
Member of 桃子视频
Ya sea que se trate solo de ti o de toda tu familia, encuentra hoy mismo una cobertura m茅dica asequible y confiable. 隆Ya lleg贸 la Inscripci贸n Abierta del Mercado! 隆Llame ahora! 832.501.3254