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Cold and flu season Temporada de influenza y resfriados

ALERT: Stay healthy this cold and flu season! Learn more

ALERTA: ¡Mantente sano durante esta temporada de influenza y resfriados! Más información

New Website! ¡Nuevo sitio web!

ALERT: We have made the Texas Children’s Health Plan website even easier to use! Click here to learn more.

ALERTA: ¡Ahora el sitio web de Texas Children’s Health Plan es aún más sencillo de usar! Haz clic aquí para más información.

Enfamil shortage updates Escasez de Enfamil Reguline

ALERT: Shortage of Enfamil products until October 31, 2024. Learn more.

ALERTA: Escasez de productos de Enfamil hasta el 31 de octubre de 2024. Más información.

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STAR Medicaid

Quality health care at no cost includes dental, prescriptions, eye glasses, and more.

Do I qualify?

Working with STAR Providers

We have a large network of doctors, hospitals, and specialists who are committed to providing you with good medical care. Our health plan was founded on the belief that you and your primary care provider (main doctor) are the 2 best qualified to care for your health. Think of your main doctor as your medical home. If you are sick, need a checkup, or if you have a medical question, call your main doctor.

STAR Provider Directory 

Choosing a primary care provider

You can pick any primary care provider in the Texas Children’s Health Plan network to be your main doctor. Each person living in your home who is a member can pick the same or a different primary care provider. You can easily search for a provider on our website. We can help you find a doctor. Call us at 866-959-2555.

Find a Provider

Click here to use our Find a Provider tool.

By Phone

If you can’t find your doctor or if you need help, call Member Services toll-free at 1-866-959-2555 (STAR).

Referral Process

Your primary care provider will give you all your routine medical care and will refer you to a specialist or hospital when needed. A referral is when your primary care provider arranges for you to go to another doctor. He or she will tell you exactly what kind of specialist or tests you need for your illness or condition.
 
Most of the time, you will need to go to your primary care provider first. If you choose to go to another doctor, you might have to pay for the services. Remember—always take your Texas Children’s Health Plan ID card and Your Texas Benefits Medicaid Card with you each time you get health care.

Other services that do not require a referral from your primary care provider

There are other certain types of health care that you can get without being referred by your primary care provider.

Those services include (when given by a Texas Children’s Health Plan network provider):

  • Emergency care

  • OB/GYN care

  • Prenatal care

  • Behavioral health services or drug and alcohol treatment

  • Texas Health Steps medical and dental checkups

  • Family planning services

  • Vision care

  • Mental health or substance use services

 
To pick a main doctor, you can use our online “Find a Provider” tool here, or you may click on one of the following links to open our provider directory. If you need help or have questions, please call Member Services.

For help with using the online directory click here for the user guide.

To request a printed provider directory, please call member services. A directory will be mailed within 5 business days at no cost to the member. The member services number can be found on the back of the ID card.