Helpful Information for Members
You recently received a letter from us about an update to our external review process for CHIP members.
The letter has a wrong phone number listed for Member Services. The correct phone number is 1-866-959-6555. Everything else on the letter is correct. We will be sending you a new letter soon. We are sorry if this has caused you any difficulty in reaching us. Click here for a copy of the letter for CHIP members.
Do not let other people use your/your child’s ID card. If the card is lost or stolen, call Member Services (toll-free) and a Member Advocate will send a new card to you.
STAR Kids: 1-800-659-5764
Texas Children’s Health Plan will host quarterly Member Advisory Group meetings to gain valuable feedback from our current members on the initiatives, services, and programs offered by the health plan. The information and member feedback gathered during these meeting will be used to guide future programs.
These meetings will last no longer than one hour. These quarterly meetings are being mandated by the state. Texas Children’s Health Plan must maintain a record of member advisory group meetings, including agendas, and minutes.
A State 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 State 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
Phone: 832-828-1001 or 1-866-959-2555
TDD 1-800-735-2989 (Texas Relay) or 7-1-1
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.
- CHIP: 1-866-959-6555
- STAR: 1-866-959-2555
- STAR Kids: 1-800-659-5764 (Service Coordination)
- TTY/TDD: 1-800-735-2989 (Texas Relay) or 7-1-1
To join, you can call: 1-877-782-6440 (STAR Kids) or 1-800-964-2777 (CHIP and STAR). For TTY/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 from 8 a.m. to 6 p.m., Monday through Friday.
In case of an emergency, go to your nearest in-network emergency room or call 9-1-1.