To find a provider - use the interactive provider search tool, also available in the upper right hand corner of the screen, to find the name or location of a health care provider, pharmacy provider, behavioral health provider, urgent care center or hospital. You can also click on the links below to view the PDF versions of the provider directories. These PDF versions are updated four times a year.
Our provider directory has a list of all types of network providers and their names, addresses, phone numbers, specialty, education, board certification, languages spoken, ages served and more. The latest directory is always on our website. Call Member Services if you need help locating an in network provider or if you’d like us to send you a printed copy.
If you have been getting health care services at a clinic and you want to keep going there, please pick one of the doctors in the clinic as your primary care provider. The primary care provider you pick needs to be listed in our provider directory.
Some of the providers that you can also pick from to be your primary care provider are: family doctors; pediatricians (for children); OB/GYNs (woman’s doctor); general practitioners (GPs); advanced nurse practitioners (ANPs); Federally Qualified Health Clinics (FQHCs); and Rural Health Clinics (RHCs).
Please look at our provider directory to get more information on primary care providers. You must pick a primary care provider who is in our Aetna Better Health of Texas network. You can get a copy of the provider directory on our website or by calling us at the toll free number listed on your id card.
Do I need to pick a primary care provider?
Yes, the majority of members enrolled are required to have a primary care provider within their health plan network.
- If you see a non-Medicaid primary care provider through your private insurance, you can keep seeing this provider.
- If you have Medicare Duals, no PCP is required. ID card will read “No PCP required’.
What is a referral?
A referral is not a requirement for the Aetna Better Health of Texas plans of benefits.
What services do not need a referral?
The Aetna Better Health of Texas plans of benefits do not require referrals for any services; however, there are services that may need prior authorization.
What if I need to see a special doctor (specialist)?
Your primary care provider can send you to another doctor if a special type of care your primary care provider cannot offer. Your primary care provider will tell you if you need to see a specialist. Some specialist services require a prior authorization.
What is a prior authorization?
It is not a referral or a pre authorization. Prior authorization is an approval that Aetna Better Health of Texas requires for certain services and medications. Some services need approval before they are given. The provider who is treating your child should get this approval. You can ask your doctor or us if an approval is needed for a service or treatment.
Give us a call – we’re here to help!
Medicaid STAR 1-800-248-7767 (Bexar), 1-800-306-8612 (Tarrant)
Medicaid STAR Kids 1-844-STRKIDS (1-844-787-5437)
CHIP or CHIP Perinate 1-866-818-0959 (Bexar), 1-800-245-5380 (Tarrant) 1-800-735-2989 (for the hearing impaired)
Behavioral health How does my child get help if they have mental health, alcohol or drug problems? Aetna Better Health covers health for your child as a whole person. That includes help for mental health problems like depression. You also can get help when you or someone else thinks your child is drinking too much or using drugs. If you need help right away, call our hotline. 24 hours a day, 7 days a week at 1‑844‑STRKIDS (1‑844‑787‑5437). Do I need a referral for this? You may go to any mental health provider in our network. You do not need to ask your child’s doctor to refer you to someone. You may need to get plan approval (prior authorization) first before you can get some services. Emergency care is covered anywhere in the United States.
Family Planning Services How does my child get family planning services? Family planning services help your child plan or control pregnancy. You do not need a referral from your child’s doctor to receive family planning services or supplies. If you are under age 21, you do not have to get permission from your parent to get family planning services or supplies. You can get family planning services from your doctor, or you can go to any family planning provider who is in our provider directory. The services you can get include:
- A yearly checkup
- An office or clinic visit for a problem, counseling, or advice
- Laboratory tests
- Prescriptions and contraceptive supplies like birth control pills, diaphragms, and condoms
- Pregnancy testing
- Sterilization services (Only if you are 21 years of age or older; Federal Sterilization Consent Form needed)
Does my child need a referral for this? You do not need a referral from your child’s doctor to get family planning services or supplies. Where do I find a family planning services provider? You can find the location of family planning providers near you online, or you can call us at 1‑844‑STRKIDS (1‑844‑787‑5437) for help in finding a family planning provider.