Understand your child's benefits

We want to make sure your child gets the covered services he/she needs.

Look at this information carefully. It will help you understand what is covered by your plan, and how you can find the right care your child needs.

The CHIP plan of benefits does not require referrals for any services; however, there are services that may need prior authorization before you can get them. If you don't know if something needs approval, check with your doctor or call  Member Services at:

1-800-306-8612 (Tarrant)
1-800-248-7767 (Bexar)
1-800-735-2989 (if deaf or hard of hearing)

Please review the Member Handbook for additional information:

Prior Authorization List (English|Spanish)

Care managers can be nurses or social workers. They work with both adults and children. Care managers can help you:

  • Learn about your health care
  • Work with your primary care provider (PCP) if you have a question
  • Plan your care with a medical team (your PCP, family and specialists)
  • Set up rides to appointments
  • Get special equipment and home health services if you need them

Children who have special medical, behavioral or educational requirements can get the help they need through the care management program. If you or your child have special health care needs, call Member Services at: 

  • 1-866-818-0959 (Bexar)
  • 1-800-245-5380 (Tarrant)
  • 1-800-735-2989 (for members who are deaf or hard of hearing)

 

We want your child to be healthy and feel good.

If your child has a chronic health condition, our Disease Management programs can help him/her stay healthy. These programs are for children suffering from asthma, diabetes, or other conditions.

Disease Management nurses will work with your child and your child’s doctor. They will come up with a plan to help you take care of your child’s condition.  

To learn more about our Disease Management programs, call Member Services:

  • 1-866-818-0959 (Bexar)
  • 1-800-245-5380 (Tarrant)
  • 1-800-735-2989 ((for members who are deaf or hard of hearing)