Questions About Your Benefits

Renewing or Repaying Benefits

Renewing Health-care Benefits

Renewing your benefits is easy. We'll send you a letter when it's time to renew your benefits. If you need to sign a renewal form you can:

To learn more, go to the Help Center at Your Texas Benefits.

Repay Benefits

If the Texas Health and Human Services Commission (HHSC) sent you a letter saying you need to repay part of your benefits, you can do that online using the HHSC online payment system.

Medicaid

In Texas, there are 5 different types of Medicaid:

The type of Medicaid coverage you get depends on where you live and what kind of health issues you have.

If you don't know what type of Medicaid you have, call toll-free 800-964-2777.

Traditional Medicaid

You get traditional Medicaid if you are not in STAR, STAR+PLUS, STAR Kids or STAR Health. To learn more, read the member handbook (PDF).

STAR

STAR is the largest managed care program in Texas. Most people who receive Medicaid in Texas are enrolled in STAR. The program primarily provides services to children, pregnant women and some families.

You can see how well some STAR health plans perform by looking at the STAR health plan report cards. These plans currently provide services in Texas:

STAR Kids

STAR Kids is Medicaid managed care program that provides benefits to children and adults 20 and younger who have disabilities. These plans currently provide services in Texas:

STAR Health

In partnership with Texas Department of Family and Protective Services (DFPS), Medicaid provides a managed care program, STAR Health, for the following groups:

  • Children in DFPS conservatorship (under 18).
  • Children in the Adoption Assistance or Permanency Care Assistance program who are transitioning from STAR Health to STAR or STAR Kids.
  • Youth age 21 years and younger with voluntary extended foster care placement agreements (Extended Foster Care).
  • Youth age 20 and younger who are Former Foster Care Children (FFCC).

More information about the STAR Health program can be found on the Texas Department of Family and Protective Services website.

STAR+PLUS

STAR+PLUS is a Texas Medicaid managed care program for adults who have disabilities or are age 65 or older. People in STAR+PLUS get Medicaid healthcare and long-term services and supports through a medical plan that they choose. To apply, visit Your Texas Benefits or call 2-1-1.

You can see how well STAR+PLUS health plans perform by looking at the STAR+PLUS health plan report cards. These plans currently provide services in Texas:

Medicare-Medicaid Plans

Some people get both Medicaid and Medicare. These plans currently provide services in Texas:

Bexar Service Area

Dallas Service Area

El Paso Service Area

Harris Service Area

Hidalgo Service Area

Tarrant Service Area

Medicaid and Lone Star Cards

Your Texas Benefits Medicaid Card and Your Texas Benefits

The Your Texas Benefits Medicaid card is your permanent card. Take it with you whenever you go to the doctor, dentist or drug store. Protect it the way you would your driver's license or credit card. If you lose or damage your card, you can order a new one by visiting Your Texas Benefits or by calling toll-free at 800-252-8263.

You can see your available Medicaid health information through Your Texas Benefits' Medicaid Client Portal. Legally authorized representatives can see their children's available Medicaid health information.

Lone Star Card

HHSC gives SNAP food benefits (formerly known as food stamps) and TANF cash help payments through the Lone Star Card. It is a plastic card that is used like a debit card to pay for items.

If your card is lost or stolen, or if you forgot your PIN (password), call us as soon as you can 800-777-7328 (toll-free).

To learn more, visit Lone Star Card Questions and Answers.

Finding Providers

Find a Doctor

You can use our search tool to find a doctor who gives Medicaid services. There are two types of searches — the Basic Search and the Advanced Search. The Advanced Search gives you more options to help you narrow your search. For example, you can look up a doctor by the language they speak, find doctors who work on the weekends and find a doctor that will see someone your age.

The Basic Search, Advanced Search and text in Spanish options are on the top of these web pages: Start your search.

Find a Drug Store

You can use our search tools to find a drug store that takes Medicaid or CHIP.

Need medical supplies?

Learn how you can get some supplies, such as insulin syringes and inhalers, at drug stores that take Medicaid.

Does your child or youth need vitamins or minerals?

Medicaid will cover the costs for some vitamin and mineral products if you have a written doctor's order (a prescription). You now can go to any Medicaid drug store to get them.

Do you know how often you can refill your drugs?

Some drugs must be used by 90 percent before you can get a refill. [List of drugs that must be used by 90 percent before refilling.] For all other drugs, you must use 75 percent before refilling. If it looks like you will run out of your drugs sooner, talk to your doctor or pharmacist. If you have questions, call 800-335-8957. When you call, pick a language and then press 6.

CHIP

Children's Health Insurance Program (CHIP) Health Plans

Children in CHIP get services through a medical plan in their area. Some CHIP plans also offer services to mothers who are pregnant. This is called CHIP perinatal coverage.

You can see how well some CHIP health plans perform by looking at the CHIP health plan report cards.

How to Pay Your CHIP Enrollment Fee

You can either pay online or by mail.

Pay Online

You may pay a CHIP enrollment fee online with a credit card. There is a $2 charge to pay online.

Pay by Mail

If you would like to pay by check or money order, you can send your payment to:

CHIP
P.O. Box 660287
Dallas, TX 75266-9792

To learn more about CHIP, visit CHIP and Children's Medicaid.

CHIP and Children's Medicaid Dental Services

Most children and teens with CHIP or Children's Medicaid coverage get their dental services through a managed care dental plan. There are two dental plans to choose from.

Those with Medicaid who do not get their dental services through one of those two plans include:

  • People with Medicaid age 21 and older.
  • All people with Medicaid, regardless of their age, who live in facilities such as nursing homes, state supported living centers, or community-based Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID).
  • Children and young adults in the state's foster care program who get their dental services through STAR Health.

CHIP and Children's Medicaid Dental Plans

Help Paying for Private Insurance

Health Insurance Premium Payment

The Health Insurance Premium Payment program (HIPP) is a Medicaid program that helps families pay for private health insurance. This program is for families who have:

  • A parent or a spouse with private health insurance
  • A child or a spouse with Medicaid

Medicaid will pay the family's private health insurance if the total cost of that insurance is less than the total cost of care with Medicaid. The total cost of the private insurance includes the premium, coinsurance and deductibles.

If approved, Medicaid may pay the private health insurance costs for the entire family and not just for the family members who get Medicaid. The family will get services through the private health insurance plan.

To learn more or to apply, visit the Health Insurance Premium Payment (HIPP) Program or call us toll-free at 800-440-0493. You also can ask us to send you an application. Write to:

Texas Health and Human Services Commission
TMHP-HIPP
P.O. Box 201120
Austin, Texas 78720-1120