To cancel an order, just call OTC Health Solutions at 1-888-628-2770 (TTY: 711). This includes a state license in good standing with the appropriate medical board, as well as a clean NPDB query. Prior authorization verifies whether medical treatment that is not an emergency is medically necessary. Drug Coverage | Blue Cross and Blue Shield of Texas This includes Foster Care Centers of Excellence (FCCOE). You can now order many of your regular or long-term medicines through the AllianceRx Walgreens Pharmacy service and have them delivered directly to your home. State and federal government websites often end in .gov. If you have provider-related inquiries, please contact our Provider Relations department: You may also call the Provider Relations representative in your region, Monday to Friday, 8 a.m. to 5 p.m.: Please ensure your email address is valid. And weve proudly served the people of Texas for over 10 years. Orders can be placed by calling 1-888-628-2770 (TTY: 711). Once you become a member, your coverage will include non-prescription OTC health and wellness items like vitamins, sunscreen, pain relievers, cough and cold medicine, and bandages. STAR Value-Added Services. Children in DFPS conservatorship (under 18). By the end of the unwinding process, Dague's research estimates that up to 750,000 Texans will lose their Medicaid health insurance. Multiple sclerosis. The emergency supply is subject to pharmacist clinical judgement. Interpersonal Violence Reduction Program (IVRP), SUD (Substance Use Disorder) Exposed Pregnancy (SEPP), Short-distance travel for errands and appointments. Yes, Medicaid coverage will continue for anyone who has coverage during the federal declared public health emergency. So lets get you started. BSWH will notify the Member by letter that an authorization request was received but cannot be acted upon until BSWH receives the missing documentation/information from the requesting Provider. You can get: For our non-discrimination notice and other language help: Espaol | | Ting Vit | | Kreyl Ayisyen | | | Franais | Polski | Portugus | Italiano | Deutsch | | | other languages, Non-discrimination notice and language assistance. Much care and preparation are needed during a pregnancy for a healthy baby to be born, and we are here with great services and rewards to help give babies a healthy start! Up to $350 for basic and major dental services for women enrolled in PREG Medicaid (TP40) and in the Cook Childrens Health Plan Baby Steps Program. Ready to learn more? These programs are free to U.S. residents who cannot afford health insurance. Your childs pharmacy benefits are administered by the Blue Cross and Blue Shield of Texas (BCBSTX) STAR Kids Plan. All Rights Reserved. Contact them at least 48 hours before your doctor visit. Aetna Better Health of Texas complies with applicable federal civil rights laws and does not discriminateon the basis ofrace, color, national origin, age, disability or sex. Community Health Choice (Community) participates in the State of Texas Access Reform (STAR) Managed Care Program (Medicaid). ATTENTION: By clicking Continue, you will leave the FirstCare Medicare Advantage pages. Courtesy: McClatchy Co. A man was killed and three people were injured in a crash after one car ran a red light Sunday afternoon on Alliance Gateway Freeway in north Fort Worth, according to . TITLE:Lots of people have questions right now. GONZALO:What if I keep my job but I get furloughed? This plan gives you Medicaid services. Or choose Go on tomove forward to Aetna.com. What's Covered | STAR | Molina Healthcare Texas Pharmacy Maximum Allowable Cost (MAC) List. STAR Kids | Texas Health and Human Services . Just have your member ID ready when placing your order. Pharmacies should bill these drugs directly to the other primary Medicare Part D plan. Hemophilia. Must be an active Texas Children's Health Plan member to receive extra benefit. Most orders will arrive in less than 7 business days, though it may take longer during peak busy times. DOES meet the criteria for a different type of Medicaid coverage, they will be moved to that type of Medicaid coverage, if it provides the same (or a better) level of coverage. To request a copy, please call FirstCare STAR Customer Service at 1-800-431-7798. Members must re-enroll every 12 months for coverage to continue. Access to Physical Fitness Programs. Make sure that Texas HHSC has your current contact information so you won't miss important updates regarding the expiration of your healthcare coverage. STAR Members must renew coverage every 6 months. As a commitment to your health and well-being, Superior HealthPlan STAR+PLUS Medicare-Medicaid Plan (MMP) offers members a benefit of $35 per calendar month in commonly used over-the-counter (OTC) items. We offer great benefits and rewards to help members get stronger and take control of their health! For a listing of clinical edits implemented by FirstCare please. Truck slams into alligator, killing pregnant woman, cops say | Fort Medicaid is the payor of last resort and provides the wraparound benefit. Expect to receive an email with tracking info once your order has shipped and another email once your order has been delivered. Plan Benefits | Texas MMP Amerigroup Submit online requests. Provider is a first time applicant to FirstCare and provisional credentialing request is based on a critical need of the members. $25 gift card (up to $100) for pregnant women for attending their first prenatal visit within 1st trimester or 42 days of enrollment, then for attending the 3rd, 6th, and 9th prenatal visits. If the letter is asking for you to take any action, please comply with this request as soon as possible. This doctor is your point of contact for services. Phone number: 1-888-345-2619; TTY users, please call 711. Business hours are 7 AM 10 PMfrom Monday Friday and 7 AM 7 PM on Saturday and Sunday. Your doctor can also submit online or call 1-855-457-0407. As a CVS Health company, were offering you this $25 OTC benefit as part of your Aetna Better Health benefits. Questions About Your Benefits | Texas Health and Human Services If you want to remain on these pages, click Cancel or close this box. Your benefits include: Doctor visits and prescription medications Dental, vision, and hearing services Hospital, urgent, and emergency care Long-term services and supports All members must qualify based on income. Your doctor can also submit online or call 1-855-457-0407. Welcome Aetna Better Health of Texas members. In Texas, there are 5 different types of Medicaid: STAR STAR+PLUS STAR Kids STAR Health Traditional Medicaid The type of Medicaid coverage you get depends on where you live and what kind of health issues you have. Even if a Provider obtained the required prior authorization, Baylor must still process a Providers claim to determine if payment will be made. The STAR plan is for children, pregnant women, newborns and adults. Over the Counter Program | Texas Medicaid | Superior HealthPlan Over-the-Counter Mail-Order Program As a Superior HealthPlan Value-added Service* STAR Health members can get $30 for commonly used over-the-counter (OTC) items every quarter, per member. You pick a medical plan that provides your Medicaid services. Just contact us. Member Portal | Aetna Medicaid Texas Learn more. If you dont want to leave your state site, choose the X in the upper right corner to close this message. When you join STAR, you pick a primary care provider (PCP) to manage your health care and treatment. This will happen for one of the following reasons: The household failed to respond to a request from HHSC like a renewal packet or H1020 Request for Missing Information, or. Our goal is to give you quality care and a great network of doctors, specialists and hospitals. Explore your Molina Healthcare of Texas Medicaid Program Yes, you can cancel your order within 30 minutes of placing it. Or choose Go on to move forwardtoYour Texas Benefits. STAR Benefits - cookchp.org Braille, and CD or other electronic form. So be sure to use up the full amount each month. If you dont want to leave your state site, choose the X in the upper right corner to close this message. 19982023 Texas Children's Health Plan. As of 7/1, you can use your OTC Benefit at over 7000 CVS locations (excluding Target and Schnucks stores). All Rights Reserved. You can also request any materials on this website in another format, such as large print, braille, CD or in another language. STAR. they will move you to the appropriate type of Medicaid coverage based on the eligibility criteria your household meets. You'll want to get PA for these medications. Receiving calls and/or text messages from Aetna Better Health of Texas that are informational and relate to my health and benefits. You can pick any PCP in FirstCares STAR network. Extra benefits valid from September 1, 2021 to August 31, 2022. b. They will give you all of your preventive and other primary care. If HHSC receives information that your household has a change in circumstances (such as income, expenses, people in the household, etc.) Texas Medicaid Plans | Aetna Medicaid Texas - Aetna Better Health Aetnaprovides infoabout COVID-19on the next page. More information about the STAR Health program can be found on the Texas Department of Child and Family Services website. This new site may be offered by a vendor or an independent third party. Cough drops, sore throat spray, digital thermometer, etc. It also determines if the treatment matches the diagnosis and that the requested services will be provided in an appropriate setting. As a Medicaid Member if you need a ride to a doctor's appointment, Access2Care can provide you with cost-effective means of transportation. Visit our How to Apply page to get assistance with applying for Medicaid. The .gov means its official. You may receive a phone call from Papa Pals. HHSC received information via a renewal packet, reported change, or from another agency that indicates the household no longer meets the eligibility requirements. You can call Monday through Friday, 9 AM to 8 PM CT. Youll need to order supplies for each benefit period by 10:59 PM CT of the last day of the month. Did you know you can change your primary care doctor on our member portal? Our Customer Advocates will be happy to help you by phone by calling. For more info about this benefit: Contact us to reach Member Services. Access to medical specialists and mental health care. Our STAR Member Resources section will give you lots of other information about how the plan works including. Texas has more uninsured residents, and a higher rate of . All members must qualify based on income. They can answer questions or help you decide what to do about your health needs. For more information. myFirstCare Self-Service (Log In/Register), Summary of utilization management program changes, Physician/Provider Advisory Group (PAG) Quarterly Meeting, Baylor Scott & White Health Plan, including Scott & White Health Plan (RightCare) and FirstCare Health Plans (FC Medicaid), would greatly appreciate your attendance at the virtual. STAR Member Handbook If you dont want to leave the member site, choose the X in the upper right corner to close this message. You can call Papa Pals to sign up. Learn more about how to keep your coverage. Texas Medicaid Plans - STAR, STAR+PLUS, CHIP Medical Plans And make sure you get the most from your benefits. Cook Childrens Health Plan Members are eligible to receive up to 15% discount on over-the-counter products purchased at Cook Childrens Pharmacy. On this page you will also find the plans OTC Product Catalog. The Texas STAR Formulary is available in paper form without charge. Over the Counter Program | Texas Medicaid | Superior HealthPlan Over-the-Counter Mail-Order Program As a Superior HealthPlan Value-added Service*, STAR+PLUS**, STAR Kids and STAR Health members can get $30 for commonly used over-the-counter (OTC) items every quarter, per member. 500,000 Texans lose Medicaid insurance as part of unwinding | Fort STAR Benefits | Texas Medicaid Amerigroup If you don't know what type of Medicaid you have, call toll-free 800-964-2777. $100 towards a Hepafilter Vacuum for Members with a moderate to severe asthma diagnosis. In store: See the OTC Item Catalog (PDF) for instructions on how to pick up your items in store. Rheumatoid arthritis. How To Apply Am I Eligible? STAR+PLUS Program Browse through the list of products and add to your basket. In partnership with Texas Department of Family and Protective Services (DFPS), Medicaid provides a managed care program, STAR Health, for the following groups: Members in the STAR Health program can get benefits like: You can get find more information on coordinating your STAR Health services here. It is permissible that a pharmacy dispense product packages in fixed dosage forms (e.g., inhalers, nebulized medications) that are unbreakable as a 72-hour supply. If you qualify for STAR, you will need to choose a health plan. Aetna Better Health provides the general info on the next page. $25 gift card gynecological visit for females 16 years and older who had a cervical cytology, cervical high risk human papilloma virus (hrHPV) testing, cervical cytology/hrHPV cotesting, or chlamydia screening. Children in the Adoption Assistance or Permanency Care Assistance program who are transitioning from STAR Health to STAR or STAR Kids. Over-the-Counter Brochure. You pick a medical plan. Additional riders if the Member or LAR cannot make other arrangements. STAR Medicaid Managed Care Program - Texas Health and Human Services Superior HealthPlan offers the services in all 254 Texas counties under a contract with Texas Health and Human Services (HHS). Visit our public health emergency site for more information. Regular checkups at the doctor and dentist. Or learn more by calling OTC Health Solutions at 1-888-628-2770 (TTY: 711). After you get your enrollment form, you will need to write in Texas Childrens Health Plan as your health plan. And we'll send it to you every month at no extra cost. This means you need them to manage your health. For some drugs, the plan limits the amount that will be covered. You can call Monday through Friday, 9 AM to 8 PM CT. You can call Monday through Friday, 9 AM to 8 PM CT. Quick tip Healthy eating classes for Adults on the STAR Program who have Type I or Type II diabetes. FirstCare is state mandated to adhere to the, The Texas Medicaid formulary and Preferred Drug List are available on the. Some people have to renew their Medicaid coverage each year. Youre going to the provider website. Adults in STAR+PLUS get Medicaid health-care and long-term services and support through a health plan that they choose. You will need Adobe Reader to view these files; this can be downloaded free of charge at Adobe's site. A 24/7 nurse hotline for caregivers and caseworkers. Aetna Better Health of Texas is part of Aetna, one of the nation's leading health care providers and a part of the CVS Health family. We want to keep members motivated by offering them rewards just for taking care of their well-being, including rewards for attending well-child checkups and more! You can also ask for info on health conditions and wellness topics in print. Can they be covered? People in STAR+PLUS get Medicaid health care and long-term services and support through a medical plan that they choose. Learn more about what's covered in each program. Treatment of special health needs and pre-existing conditions. Traditional Medicaid STAR is a no-cost Medicaid managed care plan that covers children up to age 21, some adults, and pregnant women who cannot afford health insurance. Online: a. Governor Greg Abbott today announced that nominations for the 2021 Star of Texas Awards, which honor peace officers, firefighters, emergency medical first responders, and federal law enforcement who were seriously injured or killed in the line of duty, are now open. For most of the extra benefits, allow up to 60 days for delivery of reward. The required verifications must indicate the file is clean. You do not need a referral by a PCP. Does not cover orthodontia or cosmetic services. You can use the money to spend on a variety of health products, like: Oral care, hand sanitizer, lotion, facial tissues, maxi pads, etc. We want to go above and beyond the call of duty to show we truly care for our members. You can find all the phone numbers you need on our contact us page: Just visit the provider home page to find resources for network doctors, administrators and other health care professionals. b. Superior works with many doctors, clinics and hospitals to care for children in foster care. You can use the prescreening tool. About STAR+PLUS - Molina Healthcare To view this file, you may need to install a PDF reader program. You must have Adobe Acrobat Reader or a compatible PDF reader or plugin to view the schedules. Explore STAR Kids benefits and added services, Explore CHIP and CHIP Perinatal benefits and added services, STAR (Medicaid) Member Handbook - English (PDF), STAR (Medicaid) Member Handbook - Spanish (PDF), STAR Kids Member Handbook - English (PDF), STAR Kids Member Handbook - Spanish (PDF), CHIP and CHIP Perinatal Member Handbook - English (PDF), CHIP and CHIP Perinatal Member Handbook - Spanish (PDF), Learn more about starting with your new plan, have a complaint or want to appeal a decision, non-discrimination notice and other language help, Pharmacy benefits, mail-order medicine and specialty medicine, Rides (non-emergent medical transportation or NEMT services), Interpreterservicesat no costduring any service or complaintprocess, including American Sign Language and real-time oral interpretation, Interpreter services for your medicalvisit (be sure to call48 hours before yourvisit), Info in another format, like audio CD-ROM, large print and braille, Materials in other languages if your primary language isnt English. Ray Anthony Shoulders, a 36-year-old physician's assistant at a Fort Worth pain management clinic, was indicted on one count of conspiracy to commit healthcare fraud and 11 counts of healthcare . The only exceptions are Healthy Texas Women (HTW), Community Attendant Services (CAS), and CHIP. Texas Health Steps medical and dental checkups . $25 gift card for Members 13 years of age and older who have a diagnosis of Alcohol or Drug Abuse (AOD) or dependency and receive treatment through an inpatient AOD admission, outpatient visits, intensive outpatient encounter or partial hospitalization, within 14 days of diagnosis. You can find out the income limits on our Do I Qualify? page. We'll help you understand your coverage. If you want to stay on our site, choose the X in the upper right corner to close this message. Aetna is part of the CVS Health family of companies. Call us 48 hours before at 1-833-779-3105 (TTY 711) or download the Access2Care (A2C) app. Click here to read more. Were with you every step of the way as your family prepares for what comes next. Search the FirstCare STAR Provider Directory: Call FirstCare STAR Customer Service at 1-800-431-7798. Please ensure your email address is valid. Texas Children's Health Plan offers STAR in more than 20 counties in the Jefferson and Harris Service Areas. Theyre our way of showing that we care about our members. Or access MyActiveHealth with your smartphone. Have your doctor fax in completed forms at 1-877-243-6930. Orders must be placed by 11:59 PM ET of the last day of the month. All rights reserved. It may take longer during peak busy times. If you know what plan you want to pick, go ahead and do so and return the form. $125 for prescription eyeglasses (frames and lenses) or $100 for contact lenses and contact lenses fitting fees per year. The Texas STAR Formulary is available in paper form without charge. What is STAR? Cook Children's Health Plan can also help you get the health care services you need. Texas Medicaid | Texas Medicaid Amerigroup STAR. You and your family may be eligible for benefits without knowing it. If you dont want to leave our site, choose the X in the upper right corner to close this message. (updated 7-21-2023), Hidalgo Provider Directory Prior Authorizations. You are leaving this website/app (site). Members of the Children's Health Insurance Program (CHIP) may have to pay a small copay (usually $3 or less). Or if its your first time enrolling. We can help you or your child get a ride, at no cost, to the doctor, hospital, dentist, and drugstore. To obtain a copy of the Pharmacy Provider Manual, please visit. There is a space on the form for the name and provider number. Copyright 2023 Aetna Better Health of Texas. Immune deficiency. Diaper rash ointment, unscented cleansing wipes, etc. Place '3' in "Days' Supply" but enter the full quantity dispensed. For STAR and CHIP, we're here for members in the Bexar and Tarrant service areas. We offer services like free rides to appointments and a 24-hour nurse help line. STAR members receive Medicaid health care benefits, including Texas Health Steps (THSteps) medical and dental checkups.For more details, call THSteps toll-free at 1-877-847-8377 or visit the THSteps website. CHIP Pharmacy Prior Authorization Timeline, For routine PA requests within three Business Days after receipt, For urgent PA request within 1 Business Day, STAR Pharmacy Prior Authorization Timelines. Or choose Go on to move forward to CVS.com. Medicaid clients will not be transitioned to any of these programs from another health care program during the public health emergency. Explore STAR Kids benefits and added services, Explore CHIP and CHIP Perinatal benefits and added services, STAR (Medicaid) Member Handbook - English (PDF), STAR (Medicaid) Member Handbook - Spanish (PDF), STAR Kids Member Handbook - English (PDF), STAR Kids Member Handbook - Spanish (PDF), CHIP and CHIP Perinatal Member Handbook - English (PDF), CHIP and CHIP Perinatal Member Handbook - Spanish (PDF). 1 killed, 3 injured in multiple-car accident in Fort Worth | Fort Worth See ournon-discrimination noticeto learn more. $25 gift card one-time for Members ages 6-12 years and newly diagnosed with ADHD who follow up with a practitioner within 30 days after receiving the new medication. You can call Monday through Friday, 9 AM to 8 PM CT. Non-discrimination notice and language assistance. If you want to file a complaint please call Ride Assist, Complaints at1-844-572-8195(toll free), 24/7 and TTY:7-1-1(toll free), 24/7. Please enter your recipient's email address. Your Texas Benefitsprovidesthe info on the next page. You can go to the Aetna Better Health website to learn more. Learn more about Superior HealthPlan. You can call 1-855-231-3716 to ask for a printed copy of the health survey. CHIP offers coverage for families that earn too much money to use Medicaid but cant afford to buy private health insurance CHIP Perinatal offers coverage for mothers-to-be. One (1) Baby Basics Book for all pregnant members enrolled in the Cook Childrens Health Plan Baby Steps Program. We care about the health and well-being of all of our membersas we continue to monitor the spread of COVID-19, we are committed to keeping you informed. Especially if its new to you. Need language help? Call (866) 449-6849, TTY/TDD: 711, Monday-Friday . This new site may be offered by a vendor or an independent third party. The claim is processed according to: The National Committee for Quality Assurance (NCQA) awarded FirstCare Health Plans an Accredited Status (Commercial, Medicaid, Marketplace HMO, recertified 11/2022) - reflecting our continuous work to fulfill NCQA requirements for consumer protection & quality improvement. A 72-hour emergency supply of a prescribed drug may be provided when a medication is needed without delay and prior authorization (PA) is not available. Timeline for the provider to submit the missing information. STAR+PLUS | Texas Health and Human Services STARs benefits are: You can get more information on benefits in your member handbook. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. Receiving calls and/or text messages from Aetna Better Health of Texas that are informational and relate to my health and benefits. Youth age 21 years and younger with voluntary extended foster care placement agreements (Extended Foster Care). Understanding health insurance can be tough. Prescription Drug Forms. There is a value-added service for everyone in the family through Driscoll Health Plan. Simply call Superior Member Services. TITLE:Other family members may be eligible for Medicaid even if you aren't. For more than 25 years, Texas Childrens Health Plan has focused on helping the states most vulnerable children and pregnant women get and stay healthy. Not all pharmacies carry these medications, so members may need to find a specialty pharmacy. We bring our national experience to your communities. Includes: STAR Kids is a Texas Medicaid managed care program that provides Medicaid benefits to children and adults 20 and younger who have disabilities. If you need further assistance, HHSC Managed Care can assist. Renew now. PDF Compare Extra Services STAR Medical Plans Offer in the Bexar Service Area DOES NOT meet the criteria for any other type of Medicaid coverage, they will continue in their same type of Medicaid coverage until the federally-declared public health emergency ends or federal guidance changes. Please call Member Services at1-800-964-2247for help with these benefits. You can call Ride Setup, Reservations at. Please enter all the mandatory fields for the form to be submitted, For questions or comments about your coverage, or for more information, please, Molina Healthcare Medical Insurance Marketplace, Molina's Breathe with Ease Asthma Program, Molina's Healthy Living with Diabetes Program, Molina's Healthy Living with Diabetes Program, Behavioral Health and Substance Use Disorders, H8197_23_002001_MMPTXWebsite_2023 Accepted | H8197_23_002002_MMPTXWebsite_2023 Accepted For STAR and CHIP, were here for members in the Bexar and Tarrant service areas. Please follow the instructions on any notice you get from HHSC. Please sign up and login to our MyCookChildren's Member Portal to access the forms for each of these incentives below. External link You are leaving this website/app (site). STAR Kids is Medicaid coverage for kids and adults ages 20 or younger who have disabilities. Always make sure to keep note of your confirmation number. If you dont want to leave our site, choose the X in the upper right corner to close this message. These items can be shipped to your home. If you are not a member and you have questions about Medicaid, visit yourtexasbenefits.com to learn more. Thats why were working with CVS Health to give you $25 of over-the-counter (OTC) health supplies and products. Access to the Boys and Girls club where available, at no cost to Members 6 to 21 years of age.
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