Texas STAR Kids Medicaid benefits

There are no copays for covered services.

• Primary care provider visits
• Prescription drugs
• Specialist visits
• Hospital care
• Preventive care
• Urgent care
• Emergency care
• Lab and X-ray services
• Personal care services
• Behavioral health services
• Private duty nursing
• Durable medical equipment and supplies
• Long-term services and supports including home- and community-based care

If your child has both Medicare and Medicaid, Wellpoint will provide your child’s long-term services and supports benefits. Medicare will provide your child’s primary medical care benefits.

Check your STAR Kids member handbook for a complete list of your child’s benefits.

Medical checkups, for children birth through age 20 who have Medicaid, are called Texas Health Steps. Your child should get Texas Health Steps checkups at:
 

• Birth
• 3-5 days old
• 2 weeks old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 2 years old
• 2 ½ years old

After age 2 ½, your child should visit the doctor every year. Be sure to make these appointments and take your child to his or her doctor when scheduled. These checkups can:

• Find health problems before they get worse and harder to treat.
  
• Prevent health problems that make it hard for your child to learn and grow.

There is no cost for these checkups.

Questions about Texas Health Steps? Call 877-847-8377 (877-THSTEPS) or go to the Texas Health Steps website.

Are you a seasonal farmworker? We will help you find doctors and clinics and help you set up appointments for your children. Your child can receive his or her checkup or service sooner if you are leaving the area.

Health care services for children of farmworkers (English) 

Health care services for children of farmworkers (Spanish) 

Your child may need help with everyday tasks like eating, dressing, or personal care. Our service coordinators can help you get the long-term services and supports your child needs to live at home.

Call the service coordination line at 866-696-0710 for more information.

Dental benefits are offered through a dental managed care organization. Call your child’s dental plan to find a dentist and learn about covered services:

• DentaQuest: 800-516-0165
• MCNA Dental: 800-494-6262
• UnitedHealthcare Dental: 877-901-7321

Wellpoint offers vision care through Superior Vision of Texas. To find an eye doctor and learn more about covered services, call Superior Vision of Texas at 800-428-8789 or go to the Superior Vision website.

Members can get an eye exam once every 12 months and prescription glasses (if necessary) once every 24 months.

If your child has both Medicare and Medicaid, contact your child’s Medicare plan to learn more about vision benefits.

You can get no-cost rides to your child's health care services. Wellpoint will provide rides to the doctor, dentist, hospital, pharmacy, and any other place you receive Medicaid services. Call us at least two business days before you need a ride. If you need to travel out of town, or out of your service area, call us at least five business days before you need a ride.

Wellpoint will use Access2Care to arrange all travel. Call 844-864-2443 (TTY 711) to schedule a ride.

Visit the Transportation page for more details.

Get 24-hour phone advice from a registered nurse.

Call 844-756-4600 (TTY 711).

STAR Kids Medicaid (Non-Dual) members

Your benefits include a wide range of prescription drugs. You also don’t have pharmacy copays. We work with CarelonRx to provide these pharmacy benefits.

STAR Kids Medicaid/Medicare (Dual) members

If your child has both Medicare and Medicaid, contact your child’s Medicare Part D plan to learn more about pharmacy benefits.

Review pharmacy benefits 

Healthy Rewards is a program that pays you for taking control of your child’s health. You can earn rewards for completing healthy activities like:

• Texas Health Steps well-child checkups for ages 0-20.
• Childhood and adolescent vaccines on schedule.
• Flu vaccines.

Then redeem your Healthy Rewards via the Benefit Reward Hub. To learn about other value-added benefits, visit the Extra Benefits page.

Service coordination helps you get the care and services your child needs. A service coordinator will:

• Work with you and your care team to create a service plan based on your child’s health needs and goals.
• Make sure you and your child understand the service plan and help you learn more about your care and service options.
• Help you make appointments with your child’s providers, arrange services, and get transportation, when needed.
• Coordinate all of the services you get from us and other providers and community organizations.

If you think you need a service coordinator or if you’d like to speak with one, call 866-696-0710, Monday through Friday from 8 a.m. to 5 p.m. local time.

Your child will move out of STAR Kids and into STAR+PLUS for health care after their 21st birthday. When your child turns 15, a transition specialist will work with your child’s service coordinator. They will work together to create a transition plan. This plan describes the types of services your child will need, the doctors he or she will have, and other things, like health care benefits, that will change when he or she turns 21.

We put tools and technology in your hands to make it easy to get care and services. Your Service Plan is an easy-to-use, online tool that helps you stay connected with your service coordinator. It lets you:

• Get your service coordinator’s phone number and email address.
• Send your service coordinator secure messages about your diagnoses, goals, medicines, services, and more.
• View your goals and objectives.
• Check due dates and status for goals and objectives.

To use this tool:
 

• Choose Continue to your Service Plan below.
• Log in or register first if you don't have an account.

Continue to Your Service Plan