The right plan for kids with special needs.
That means your child is at risk of losing Long Term Services and Supports (LTSS) services. Call us today to schedule an assessment. It only takes a couple of hours, and we will come to your home. We want to help create a healthier future for your child.
Please call us today! STAR Kids Member Services: 1-800-659-5764
For more than 25 years, Texas Children’s Health Plan has focused on helping the state’s most vulnerable children and pregnant women get and stay healthy.
We are the plan that more people trust with their family’s health in Texas’s Harris, Jefferson and the Northeast coverage areas. And we have the state’s highest ratings for patient satisfaction from the National Committee for Quality Assurance (NCQA), along with a 3.5 star overall rating.
Our members can choose from a large range of top-quality healthcare providers and hospitals that are located near where they live and work. In addition, they also get exclusive access to The Center for Children and Women clinics.
Texas Children’s Health Plan offers no-cost health coverage for children and young adults under the age of 21 with disabilities who cannot afford health insurance.
STAR Kids is a Medicaid-managed care plan. This plan helps children and young adults under the age of 21 with disabilities. We offer STAR Kids in the Harris, Jefferson and Northeast Service Areas.
What does STAR Kids cover? How does it work?
Star Kids is similar the STAR (Medicaid) program. It offers coverage for children who cannot afford health insurance but offers a range of additional services to help members with disabilities.
STAR Kids Benefits:
- Prescription drugs.
- Hospital care.
- Primary care.
- Specialty care.
- Preventive care.
- Personal care services.
- Private duty nursing.
- Durable medical equipment and supplies.
- Long-term services and supports
You can get more detail on what is covered in your Member Handbook.
Can I sign up for STAR Kids?
You can sign up for STAR Kids if you meet the income and other requirements. You can find out the income limits on our “Do I Qualify?” page. If your income is too high for the Star Kids program, you may be able to sign up for the CHIP program. Give us a call at 1-800-990-8247, and we can give you assistance and answer any questions.
Depending on your situation, you will have a choice to join STAR or Star Kids for your coverage. If you are a STAR member who needs additional services, you can also switch to STAR Kids, depending on your situation. However, there are some instances where you must join STAR Kids.
How do I apply for STAR Kids?
We’re with you every step of the way as your family prepares for what comes next.
To apply for STAR Kids, you will need to fill out an application. Click here to visit our “How to Apply” page to get assistance with applying for Medicaid. If you need additional help, please call 1-888-559-7526.
What should I do now?
Use the personal worksheet that came with your letter to help you get ready to choose a health plan. You will get a packet in the mail. It will have a letter that will tell you more about STAR Kids and the health plans in your area. It will also help you choose a health plan.
How can I pick a Doctor?
Once you choose a health plan, you will also need to pick a Primary Care Provider for your care. They will give you all of your preventive and other primary care. They will also set up referrals if you need medically necessary specialist care.
You can choose a doctor that is connected with Texas Children’s or one who is not. The choice is yours. The great part is that we have more than 27,000 providers in our network.
You can find a doctor near you by using our online search.
What if I have more questions?
Click here to view our STAR Kids “Frequently Asked Questions” guide.
You can also review our STAR Kids Member Resources section. This will give you lots of other information about how the plan works including:
- Access to your handbooks and Evidence of Coverage
- Finding out how to replace a lost ID Card
- Information on Your Rights and Responsibilities
- Information about our privacy practices
- Info on filing complaints and appeals, as well as fraud and abuse
Everyone will get:
- Medicaid services like you get now.
- A health plan that offers extra services not covered by Medicaid.
- Help finding doctors who will take Medicaid. A STAR Kids nurse, social worker, or other professional (a service coordinator) will help you with this. They will also work with your main doctor to make sure you get the care you need.
Long-Term Services and Supports:
STAR Kids offers long-term services and supports if you need them. Long-term services and supports are things that can help in your home with daily activities. Also, we can help make changes to your home so you can safely move around.
- If you get services through a Department of Aging and Disability Services (DADS) intellectual and developmental disability (IDD) waiver, the Youth Empowerment Services (YES) waiver, or live in an Intermediate Care Facility (ICF-IID), you will get certain LTSS through your health plan, but you will continue to get your waiver or facility long-term services and supports through your waiver or facility, the way you do today.
- If you do not get services through a DADS IDD waiver, YES, or ICF-IID, you will get all your LTSS services through the STAR Kids health plan you pick.
- If you get services through the Medically Dependent Children Program (MDCP) waiver, you will get all your LTSS through the STAR Kids heath plan you pick.
If you are covered by Medicaid only, STAR Kids offers:
- A main doctor, nurse or clinic (a primary care provider). You will get most of your healthcare through this provider. The main doctor also can refer you to specialists, if needed.
- Medicaid services like you get now, plus:
- Long-term services and supports provided (as described above).
- Service coordination through the STAR Kids health plan you pick.
- Extra services offered by the STAR Kids health plan you pick.
If you live in an ICF-IID or get services in a DADS IDD waiver program, STAR Kids offers:
- A main doctor, nurse, or clinic (a primary care provider). You will get most of your healthcare through this provider.
- The main doctor also can refer you to specialists, if needed. All the Medicaid services you get now.
- Long-term services and supports, the same way you have today.
If you get Medicaid and Medicare (dual eligible Members), STAR Kids offers:
- No changes in your Medicare benefits. You will still use Medicare for basic medical services and medicines ordered by your doctor. You will use STAR Kids for your Medicaid long-term services and supports.
Healthy Rewards Program
We don’t only provide great health care for your family — we reward you just for being a member! Texas Children’s Health Plan offers exciting extra benefits for your family to enjoy as we help you plan for a healthy future.
Health and Wellness:
Good health starts with a healthy lifestyle. We want to keep members motivated by offering them rewards just for taking care of their well-being, including rewards for attending well-child checkups and more! Learn more.
Extra Help for Families:
We want to go above and beyond the call of duty to show we truly care for our members. We offer services like free rides to appointments and a 24-hour nurse help line. Learn more.
Much care and preparation are needed during a pregnancy for a healthy baby to be born, and we are here with great services and rewards to help give babies a healthy start! Learn more.
Healthy Play and Exercise:
Being active has both physical and mental benefits. We offer great benefits and rewards to help members get stronger and take control of their health! Learn more.
*Restrictions and limitations may apply. Age range may vary by plan. Extra benefits valid from September 1, 2023 to August 31, 2024. Must be an active Texas Children's Health Plan member to receive extra benefit.
The Consumer Directed Services (CDS) Option allows you, or your representative, to self-direct your services.