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Need help finding a provider or setting up a visit?
Call Member Services at 1-888-887-9003, TTY 7-1-1, Monday-Friday 8 a.m.-8 p.m. or email memberservices_uhccp@uhc.com to get help finding a provider or setting up a visit.
Children's Health Insurance Program (CHIP)
CHIP
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.
Texas members who have questions about Coronavirus (COVID-19), can visit the Texas Health & Human Services at https://www.dshs.texas.gov/coronavirus/
Medicaid benefits are extended until further notice, and Texas HHS will continue to provide updates to the public during the coming months. Texans in need can apply for benefits, including SNAP and Medicaid, at YourTexasBenefits.com or use the Your Texas Benefits mobile app to manage their benefits. Read the news release in English or Spanish.
Need help finding a provider or setting up a visit?
Call Member Services at 1-888-887-9003, TTY 7-1-1, Monday-Friday 8 a.m.-8 p.m. or email memberservices_uhccp@uhc.com to get help finding a provider or setting up a visit.
Benefits & Features
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 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:
- 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, 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:
- 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®
Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up.
We will help you:
- Choose a pregnancy provider and a pediatrician (child’s doctor).
- Schedule visits and exams and arrange rides to your visits.
- Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
- Get supplies, including breast pumps for nursing moms.
- Connect with community resources such as Women, Infants and Children (WIC) services.
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 at a doctor visit or an urgent care center.
- Suggest you go right to the emergency department.
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
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.
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
Member Resources
Texas Children's Health Insurance Program (CHIP)
Toll-Free Telephone Numbers
Member Services
8 a.m. to 8 p.m. Monday through Friday
1-888-887-9003 TDD/TTY (for hearing impaired 711)
- After hours, please contact NurseLine.
- Se Habla Español.
- Interpreter services available.
- How to access covered services.
Behavioral Health and Substance Abuse Services
(for CHIP members and CHIP Perinate Newborn members)
Optum Behavioral Health
- Available 24 hours, 7 days a week.
- Interpreter services available.
- Authorizations, referrals and benefit verification.
- Se Habla Español.
24/7 NurseLine
Available 24 hours a day, 7 days a week
If you have an emergency or a crisis, call 911.
Dental Care
(for CHIP members and CHIP Perinate Newborn members)
DentaQuest
1-800-508-6775
MCNA Dental
1-855-691-6262
Texas CHIP Program Helpline
1-800-647-6558
Texas Health and Human Services Commission
1-800-252-8263
Vision Care
1-888-887-9003 (for CHIP members and CHIP Perinate Newborn members)
Prescription Drugs
1-888-887-9003
Medicaid Fraud Notice from Health and Human Services Commission (HHSC)
Medicaid Fraud Notice
Important notice about Medicaid Fraud.
For information on Disaster Assistance click here.
Zika Help - Mosquito Repellent Is Now a Benefit
Zika Help
Texas Medicaid now covers certain mosquito repellent products as a Medicaid benefit for the prevention of Zika virus.
Learn more about the details of coverage.
National Flu Campaign Questions and Answers
National Flu Campaign Questions and Answers
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National Flu Campaign Questions and Answers - English (Opens in a new tab)
(pdf 63.85KB)
(Last Updated:
11/12/2020)
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National Flu Campaign Questions and Answers - Español (Opens in a new tab)
(pdf 72.65KB)
(Last Updated:
11/12/2020)
Just for Teens
Just for Teens
Member Handbook
Member Handbook
Advance Directives
Appeals Addendum
Prior Authorization
Prior Authorizations
- With respect to a member who is hospitalized at the time of the request UHC will issue a coverage determination within 1 business day. For members who are not hospitalized at the time of a routine prior authorization request, within 3 business days or up to 72 hours for expedited authorization requests.
- UHC will send a request for additional information if a decision cannot be made based on the information submitted within the initial request. The request will include a list of documents that are needed. For members under the age of 21, UMCM 3.22 is followed and the authorization decision can be pended for up to 7 days from the request date before a coverage determination will be issued to allow additional time for the necessary information to be submitted.
- Our current prior authorization lists are broken out by when they went into effect and are located here.
- UHC’s telephone, fax and provider portal link are listed at the top of each of our Prior Authorization documents so we can be easily contacted with any questions.
- Eligibility and benefits information on UHC’s website can be found here.
- Medicaid MCOs are responsible for providing all services and benefits available to clients of the Medicaid Fee-for-Service (FFS) Program to the MCO’s Medicaid Members, in the same amount, duration, and scope as is available through FFS as reflected in the state plan under Title XIX of the Social Security Act Medical Assistance Program and detailed in the Texas Medicaid Provider Procedures Manual (TMPPM).
- The TMPPM is located here.
- Members may also call into member services to clarify prior authorization requirements or obtain assistance with a request.
- STAR+PLUS, STAR and CHIP: 1-888-887-9003
- STAR Kids: 1-877-597-7799
- MMP: 1-800-256-6533
- Medicaid MCOs are responsible for providing all services and benefits available to clients of the Medicaid Fee-for-Service (FFS) Program to the MCO’s Medicaid Members, in the same amount, duration, and scope as is available through FFS as reflected in the state plan under Title XIX of the Social Security Act Medical Assistance Program and detailed in the Texas Medicaid Provider Procedures Manual (TMPPM).
Member Newsletters 2016 - Current
2021
Winter
2020
Fall
Summer
Spring
Winter
2019
Fall
Summer
Spring
Winter
2018
Fall
Summer
Spring
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2017
Fall
2016
Spring
Member Newsletters Prior to 2016
2015
Fall
Summer
Spring
Winter
2014
Fall
Summer
Spring
Winter
2013
Fall
Summer
Spring
Winter
Member Advisory Committee Meetings
Member Advisory Committee Meetings
Children's Health Insurance Program (CHIP) Advisory Committee Meetings
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Member Advisory Committee Meetings - English (Opens in a new tab)
(pdf 77.84KB)
(Last Updated:
11/12/2020)
Time to See Your Doctor?
It’s important to get medical care when you need it. Call your doctor’s office to make an appointment. Tell them the reason for the visit. This will help them make the appointment within the right time frame.
Housing Resources
Housing Resources
Learn more about housing support.
Housing Resource List by County
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Housing Resource List by County - English (Opens in a new tab)
(pdf 149.13KB)
(Last Updated:
11/12/2020)
Annual Care Checklist
Annual Care Checklist for kids
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Annual Care Checklist for kids - English (Opens in a new tab)
(pdf 99.75KB)
(Last Updated:
11/12/2020)
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Annual Care Checklist for kids - Español (Opens in a new tab)
(pdf 101.68KB)
(Last Updated:
11/12/2020)
Annual Care Checklist for Women
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Annual Care Checklist for Women - English (Opens in a new tab)
(pdf 96.42KB)
(Last Updated:
11/12/2020)
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Annual Care Checklist for Women - Español (Opens in a new tab)
(pdf 98.00KB)
(Last Updated:
11/12/2020)
Annual Care Checklist for Men
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Annual Care Checklist for Men - English (Opens in a new tab)
(pdf 96.03KB)
(Last Updated:
11/12/2020)
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Annual Care Checklist for Men - Español (Opens in a new tab)
(pdf 97.81KB)
(Last Updated:
11/12/2020)
Learn More
Children's Health Insurance Program (CHIP)
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