Learn soccer from the pros!

Sign up June 27 for our July 14 soccer clinic with the Houston Dynamo.

Make the best decision

Get low-cost health coverage for pregnant women, children, and adults.

Introducing STAR Kids

The right plan for kids with special needs.

Pregnancy assistance, prenatal program, and a whole lot more!

First-time mom? Join the Nurse-Family Partnership for extra support during your pregnancy.

Everything you need in one place.

We put your family at the center of care. The Center for Children and Women.

Who We Are

Texas Children’s Health Plan was founded in 1996 by Texas Children’s Hospital. We cover kids, teens, pregnant women, and adults. If you qualify for Medicaid or CHIP, we have a large network of doctors and resources to care for your needs.

  • More than 6,250 doctors
  • More than 7,811 specialists
  • More than 221 hospitals

Community Events

Member Events

Helpful Information

24-Hour Nurse Help Line

Before going to the Emergency Room, call the Nurse Help Line (unless it is an emergency). We are available 24-hours a day, 7 days a week. We speak English or Spanish. We also have interpreters available by phone who speak 140 different languages.

1-800-686-3831 or TDD 1-800-735-2989

Our Member Services team is ready to take your call from 8 a.m. to 5 p.m., Monday through Friday. After hours, on weekends and holidays, our answering service is ready to help you and/or take your messages. A Member Service Advocate will return your call the next business day. We speak English or Spanish. We also have interpreters available by phone who speak 140 different languages. Emergency Service and Behavioral Health services are available 24 hours a day, 7 days a week.

Member Services

  • CHIP: 1-866-959-6555
  • STAR: 1-866-959-2555
  • STAR Kids: 1-800-659-5764
  • TDD: 1-800-735-2989

To join, you can call: 1-877-782-6440 (STAR Kids) or 1-800-964-2777 (CHIP and STAR). For TDD call 1-800-735-2989.

Not a member? Call our Marketing Hotline at 1-800-990-8247 from 8 a.m. to 5 p.m., Monday through Friday. One of our representatives will be happy to assist you. You can also call the enrollment broker at 1-800-964-2777.

In case of an emergency, go to your nearest in-network emergency room or call 9-1-1.

Emergency Service and Behavioral Health services are available 24 hours a day, 7 days a week.We speak English or Spanish. We also have interpreters available by phone who speak 140 different languages.

Behavioral Health/Substance Abuse Hotline:

  • CHIP: 1-800-731-8528
  • STAR: 1-800-731-8529

(no provider referral needed)

Customer Service

Providers can use this number for claims, inquiry, questions and information about CHIP, STAR, or STAR Kids products and to check eligibility/benefits.

Phone: 832-828-1004
Toll free: 1-877-213-5508

Telephone TouCHPoint

Texas Children’s Health Plan’s automated Telephone TouCHPoint system allows Texas Children’s Health Plan providers to check eligibility, benefits, and claims status after hours. The service is available 24 hours a day, 7 days a week. To access Telephone TouCHPoint call 832-828-1007. Enter the member’s identification number and the provider’s NPI number.

Telephone TouCHPoint: 832-828-1007
Fax: 832-825-8777

 

What is CHIP?

The Children’s Health Insurance Program (CHIP) offers low-cost health coverage for children from birth through age 18. CHIP is designed for families who earn too much money to qualify for Medicaid but cannot afford to buy private health coverage.

We offer CHIP in more than 20 counties in the Jefferson and Harris Service Areas.

Click here to learn more about CHIP.

What is STAR?

STAR is a Medicaid-managed care plan. This plan helps family members of any age. Texas Children’s Health Plan offers STAR in more than 20 counties in the Jefferson and Harris Service Areas. Learn more about STAR.

Click here to learn more about the STAR program.

What is STAR Kids?

STAR Kids is a Medicaid-managed care plan. This plan helps children and young adults under the age of 21 with disabilities. Texas Children’s Health Plan offers STAR Kids in the Harris, Jefferson and Northeast Service Areas.

Click here to learn more about the STAR Kids program.

How is the Texas Vendor Drug Program (VDP) used for Texas Children's Health Plan Medicaid members?

Navitus is the provider for drug store services for members. The Texas VDP maintains and publishes the Texas VDP Formulary and the associated PDL. It also maintains and publishes the clinical guidelines for drugs not on the PDL which require pre-approval, and are used by Navitus to give benefits for Texas Children's Health Plan STAR and CHIP members.

What drug stores does Navitus have contracts with?

Navitus has contracts with more than 95% of the VDP providers in Texas. The Navitus drug store network includes national chain drug stores such as Walgreen's, CVS, HEB, Wal-Mart, Target, and Kroger. And many others. Navitus' drug store network can be found here.

Contact Member Services at 1-866-959-6555 (CHIP) or 1-866-959-2555 (STAR) if you need help finding a drug store.

We want you to have the best resources for your health. Here is a list of helpful websites and links to our vendors:

Prescriptions

Navitus

Vision care

Superior Vision
1-800-879-6901

Dental care
Your child will have one of the following dental plans:

DentaQuest
1-800-508-6775
MCNA Dental
1-800-494-6262

If you don’t know who your child’s CHIP dental plan is, call CHIP toll-free at 1-800-647-6558.

A fair hearing is a chance for you tell the reasons why you think the services you asked for and couldn’t get should be allowed.

Can I ask for a State Fair Hearing? If you, as a member of Texas Children’s Health Plan, disagree with the health plan’s decision, you have the right to ask for a fair hearing. You may name someone to represent you by writing a letter to the health plan telling them the name of the person you want to represent you. A doctor or other medical provider may be your representative. If you want to challenge a decision made by Texas Children’s Health Plan, you or your representative must ask for the fair hearing at any time up until 90 days of the date on the health plan’s letter with the decision. If you do not ask for the fair hearing within 90 days, you may lose your right to a fair hearing.

To ask for a fair hearing, you or your representative should either send a letter to the health plan or call:

Texas Children’s Health Plan
Attention: Appeals Department NB8390
PO Box 300709
Houston, TX 77230
Fax: 832-825-8796
Phone: 832-828-1001 or 1-866-959-2555
TDD 1-800-735-2989 (Texas Relay) or 7-1-1

Click here for more information on Fair Hearings

 

CHIP Perinatal

Texas Children’s Health Plan offers CHIP perinatal services. CHIP prenatal is no-cost health coverage for pregnant women. To get CHIP perinatal, you must:

  • Meet certain income requirements.
  • Not qualify for Medicaid.
  • Not have any other health coverage.

Click here to learn more about CHIP Perinatal.