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 Kids 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. If you have a primary care provider through another insurance, you may keep seeing your primary care provider. Each person living in your home who is a member can pick the same primary care provider or a different one. You should pick a doctor with an office location and office hours that are convenient for you. The names, addresses, and phone numbers of primary care providers can be found in the Texas Children’s Health Plan Provider Directory. If you like the doctor that you see now, you can continue to see them if they are listed in the directory. If you have trouble picking a primary care provider, call Member Services at 1-800-659-5764. We will be glad to help.
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 1-800-659-5764 (STAR Kids)
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
For Dual-Eligible Members
If you are a dual-eligible member, you have Medicare coverage and should receive your primary, acute, and some behavioral health services from your Medicare provider. Texas Children's Health Plan will provide your long-term care services, Medicaid covered behavioral health services not covered by Medicare, and coordinate with your Medicare providers. If you have any questions, please talk with your Service Coordinator, or you may call 1-800-659-5764 to speak to one of our Member Services advocates.
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.
