Children's Health Insurance Program (CHIP)

Medicaid

Not all Texas CHIP plans are alike. With ours, your child gets extras that other plans don’t offer. View the list of benefits below to see all that our plan covers. It’s for children and young adults up to age 20, and pregnant women who don’t qualify for Medicaid. We also offer additional services called Value Added Services (VAS). View the list below to see what CHIP includes.

Aransas, Austin, Bee, Brazoria, Brooks, Calhoun, Chambers, Fort Bend, Galveston, Goliad, Hardin, Harris, Jasper, Jefferson, Jim Wells, Karnes, Kenedy, Kleberg, Liberty, Live Oak, Matagorda, Montgomery, Newton, Nueces, Orange, Polk, Refugio, San Jacinto, San Patricio, Tyler, Victoria, Walker, Waller, and Wharton.

Benefits & Features

Well and Sick Care

Get the assistance your child needs to grow up healthy — or to get better if he or she is injured or sick. That includes:

  • Medicines. Fill your child's prescriptions at local pharmacies.
  • Vision. Includes your child's exams and $105 toward frames or lenses.
  • Vaccines and Immunizations. Routine shots to help keep your child healthy.

Nothing is more important than the health and well-being of you and your baby. That's why our CHIP benefits for pregnant moms include:

  • Prenatal Visits. Care for you before your baby is born.
  • Choose a Birth Center. Deliver at your choice of hundreds of hospitals across Texas.
  • Healthy First Steps®. Extra support to help you and your baby stay healthy.
  • Infant Care Book. Helpful advice about newborns for expecting moms.

If your child has a special health care need, you can count on us. Our CHIP plan will provide the extra care and services he or she needs. Benefits include:

  • Case Manager. Personal support from an experienced professional.
  • Asthma Care. Exams, testing and supplies are covered.
  • Mental Health. Counseling and other treatments are available.

Help protect your child's sight, hearing and smile with these benefits:

  • Vision. Includes exams and $105 toward frames or contact lenses.
  • Hearing. Screenings and therapies, if needed, are provided.
  • Dental. Checkups, routine and emergency care are covered.

Get medical equipment and supplies to manage your child's health. Benefits include:

  • Personal Care. Someone to help you with your child's in-home care.
  • Equipment and Supplies. Your child's in-home medical safety equipment is covered.

Sometimes you might need a little extra help using your child’s health plan. For those times, you can rely on:

  • Transportation. We pay for rides to and from medical visits or the pharmacy.
  • Interpreters. Interpreters can be at children's medical visits.
  • Language Help. Translated medical materials are available at no cost.
  • Member Services. Call 24/7 for answers about your child's benefits.

Read about all the extras your child could get with our CHIP plan:

  • Healthy Rewards. Earn rewards for your child's preventive services.
  • Programs for Kids and Teens. Free Boys & Girls Club memberships.
  • Weight Control. Get 13 vouchers toward local Weight Watchers programs for kids.
  • Extra Benefits. Sports and school physicals offered at no cost.
  • NurseLineSM. Speak with a registered nurse 24/7.

Value Added Services

Asthma and COPD Support

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:

  • Manage flare-ups.
  • Reduce symptoms.
  • Let your child stay active.

Case Management

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 your child can focus on getting 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 this doctor is not in our network, we can help you find a new one close to you.

Your PCP is your main doctor for:

  • Preventive care.
  • 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.

Dental Care

Checkups 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:

  • Hospital bed.
  • Oxygen tank.
  • Walker or wheelchair.

Extra Benefits

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.

Healthy Rewards

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.

Hospitalization

This plan pays for all your child's expenses related to a hospital stay.

This includes:

  • Nursing care.
  • 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.

Interpreters

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.

Language Help

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.

Medicines

We make getting your child's medicine easy.

There are no copays for covered drugs. You can fill your child's prescriptions at:

  • Local pharmacies.
  • Services that deliver routinely right to your door.

We also cover over-the-counter medicines with a written order from your doctor.

Member Services

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

Mental health is as important as physical health. That's why we have the same coverage for both.

Required care is covered. This includes:

  • Behavioral therapy.
  • Substance abuse treatment.

No Copays

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.

NurseLine℠

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 for your child at a doctor visit or an urgent care center.
  • Help you know when to go to the emergency room.

Prenatal Visits

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:

  • Homework.
  • Mentoring.
  • Coaching.

Quitting Tobacco

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.

Transportation

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.

Vision Care

See life more clearly with routine eye exams and glasses, if needed.

We also include:

  • Prescription lenses.
  • Medicaid approved frames.
  • New eyeglasses every two years.

This benefit is offered by March Vision Care.

Weight Control

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.

Member Resources

View Available Resources

Learn More

Children's Health Insurance Program (CHIP)