Individual care to help control your child's asthma.
Does your child have trouble managing asthma or COPD symptoms? A nurse who specializes in breathing issues can really help. Your child will get a customized treatment plan and medicine to:
Let your child stay active.
Does your child have a serious health problem? If so, our case managers are in your corner. They will:
Explain medical terms in plain language.
Coordinate your child's doctor appointments.
Provide your care team with your child's medical records.
Your case manager will stay with your child throughout the medical journey. He or she will:
Think beyond your child's medical needs.
Make sure you have support at home.
So you can focus on helping your child get better.
Choice of Doctor
Your child gets a primary care physician (PCP) who is his or her main doctor. Use the Doctor Lookup tool to see if your child's doctor is in our network.
If your child doesn't have a doctor or if his or her doctor is not in our network, we can help find a new one close to you.
Your child’s PCP is his or her main doctor for:
Treatment for injuries or sickness.
Referrals to specialists for certain conditions.
Choose a Birth Center
Where to deliver your child is an important choice. That's why you can pick from hundreds of hospitals across Texas.
We encourage you to tour the hospital’s birthing center. This way you will be familiar with it. And you'll be more relaxed when you deliver your baby.
Checkups, routine and emergency care are covered.
Exams and cleanings every six months help your child develop strong and healthy teeth and gums. If there is a dental problem that needs to be fixed, that's covered as well.
Equipment and Supplies
Your child's health and safety at home are important.
Our plan covers medical equipment ordered by your child's doctor or case manager. This includes:
Walker or wheelchair.
Sports and school physicals at no cost to you.
Our plan covers up to two free physicals each year so your child can:
Go to camp.
Join a team.
Play a school sport.
Healthy First Steps®
You may receive help and advice from your mom, aunts, sisters and girlfriends. Yet every pregnancy is different. This program will support you through your pregnancy.
We help you:
Find a doctor for you and your baby.
Learn resources for nutrition, fitness and safety.
Get supplies, including breast pumps for nursing moms.
An ounce of prevention can be worth a pound of cure. It can also be worth great rewards.
Your child can earn great gifts for things like getting his or her yearly well-child exam.
This plan pays for all your child's expenses related to a hospital stay.
Room and board.
Supplies and equipment.
Treatment and therapies.
Diagnostic tests and exams.
After your child leaves the hospital, we watch over his or her care. We make sure your child gets follow-up care to continue healing at home.
Your child's doctor and you need to understand each other. Not speaking English well makes this difficult. We can arrange for a medical interpreter to be at your child's appointment.
We have people at our phone centers that speak more than one language. A service lets us connects with others that speak hundreds of languages.
You can ask to receive information in another language. Then anything we will write to you will only be in that language. This is provided at no cost to you.
We make getting your child's medicine easy.
There are no copays for covered drugs. You can fill your child's prescriptions at:
Services that deliver routinely right to your door.
We also cover over-the-counter medicines with a written order from your doctor.
Sometimes you might need a little help understanding your health care options. With us, you have someone you can call 24/7. We'll answer your questions simply and completely.
We can also help you find:
Home care providers.
Dentists and vision providers.
Adult Day Health Centers.
Mental health is as important as physical health. That's why we have the same coverage for both.
Required care is covered. This includes:
Substance abuse treatment.
You pay nothing for well-child or well-baby visits, covered drugs or immunizations.
While your family's health care is low-cost or free, the care quality is high. You get:
Care from highly skilled and compassionate doctors.
Treatments at respected hospitals and clinics.
Prescription drugs and over-the-counter medicines.
Medical questions and situations come at inconvenient times. When you have questions about your child's health, you can call a trained nurse 24 hours a day, 7 days a week.
Our NurseLine nurses will:
Listen to the symptoms.
Guide you on caring for your child.
Advise you about getting care at a doctor visit or an urgent care center.
Suggest you go right to the emergency department.
Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.
All recommended prenatal clinical visits and tests are covered by our plan.
At these visits, the clinic will:
Make sure both you and your baby are healthy.
Explain what to expect at each stage of your pregnancy.
Answer your questions.
Programs for Kids and Teens
Kids with positive role models make more healthy choices. That's why we provide free memberships to the Boys & Girls Clubs in your area.
Along with fun and games, these clubs offer help with:
You know the bad health effects of smoking. You know you need to quit. We will support you while you quit with coaches and supplies. The only thing you won't get from us is a lecture.
Whether you live in the city or in the country, rides are available. Our plan provides round trips to and from plan locations. This includes trips to and from the pharmacy to fill your prescriptions.
Vaccines and Immunizations
All of the immunizations your child needs are covered.
Your child will get the care, eyeglasses and treatment to see life more clearly. Coverage includes $105 each year toward frames or contact lenses.
This benefit is offered by certain stores and retailers.
Get 10 vouchers toward local Weight Watchers programs for kids.
Weight Watchers helps children develop good eating habits and become more active. So your child will continue to grow and reach a healthy weight. The program also helps kids learn to make good choices about food and snacks.
Well Child Care
Preventive checkups, shots, eye and hearing exams.