Choosing a Health Plan

After you're approved for Medicaid or CHIP, you must pick a health plan. We will send you a packet in the mail when it's time to choose a health plan. The packet will include facts about each health plan.

You will have at least two plans to choose from. Your health plan choices depend on where you live (PDF) and the program you are enrolled in. The packet will tell you which program you are in. Below is a list of programs:

  • STAR is a program for children, newborns, pregnant women, and some families.
  • STAR+PLUS is a program for adults with a disability, people age 65 and older, and women with breast or cervical cancer.
  • STAR Kids is a program for children and adults age 20 and younger with a disability.
  • CHIP is a program for children and unborn children in families that earn too much money to qualify for Medicaid but cannot afford private insurance.

If you don't choose a health plan, we will choose one for you. If you lose your Medicaid coverage, but are reapproved within six months, you will be re-enrolled into your old health plan.

How to Choose a Health Plan

When picking a plan, think about the following:

  • Are doctors you already use and like covered by the plan?
  • How is the plan rated on issues that are important to you and your family?
  • What value-added services are available through the plan?

We also provide tools to help you choose the best plan for you and your family.

Find a Doctor

Each medical plan has a list of providers — such as doctors and clinics — you can go to for health care. When you pick a health plan, you will also choose a main doctor.

If you want to stay with the doctor you have now, ask them which plans they work with, or use the search tools available on the health plan websites to see if they are listed as a provider.

Health Plan Report Cards

People across Texas shared their thoughts about their health plan, and rated them, one to five stars, on the services their plan provided. You can compare plans using the overall ratings or by looking at the services that matter the most for you and your family.

You can view the report cards on the Managed Care Report Cards page. Click the program you are enrolled in and find your service area to see plans available to you.

Value-added Services Charts

Value-added services are extra services included in your health plan, like a 24-hour nurse line or additional help for members with asthma.

Use the charts below to explore what value added services each health plan offers.

Changing Your Health Plan

If your current health plan leaves your service area, you will have to pick a new plan.

  • If you're enrolled in a Medicaid plan, you can choose to change your health plan at any time.
  • CHIP members can only change their plans during their first 90 days of enrollment.
  • CHIP Perinatal members can change their plans during their first 120 days of enrollment.

Changes take between 15 to 45 days. If you would like to change your plan you can call the Texas Enrollment Broker Helpline at 800-964-2777 or log into the Your Texas Benefits account.