CHIP and STAR Medicaid Benefits

It’s all part of the plan.

As a member of Dell Children’s Health Plan, you get all of the coverage and benefits that come with the CHIP or STAR Medicaid programs. If you have questions about your benefits, we’d love to help. Please call us at 1-855-921-6284 (TTY 7-1-1).

CHIP and STAR Medicaid covers:

  • Regular medical check-ups and office visits
  • Prescription drugs
  • Vaccines
  • Hospital services (if you need to stay at a hospital or just come for a few hours)
  • Emergency room and ambulance services
  • Eye exams and glasses for children and adults
  • Dental exams (only for under 21)
  • Texas Health Steps visits (STAR Medicaid members only)
  • Annual well checks (CHIP members only)
  • Mental health services for the treatment of alcohol and drug addiction
  • Medical supplies
  • X-rays
  • Laboratory tests
  • Medical advice from a pediatric specialist in our network
  • Being able to meet with a mental health doctor
  • Treatment for special health-care needs:
    • Physical therapy
    • Home healthcare
    • Foot care
    • Speech therapy
    • Occupational therapy (for members who need extra help learning things like how to hold a pen or button their clothes)
    • Transplants
  • Treatment of pre-existing conditions (pre-existing is any medical need you had before getting on the health plan)
  • Rides to medical appointments
  • Interpretation and translation services
  • Care for women’s health:
    • Pregnancy care and prenatal care
    • Nurse/midwife care
  • Plus many extra benefits!

Benefits for Pregnant Moms through CHIP Perinate

  • Up to 20 prenatal visits
  • Prescription drug coverage
  • Labor and delivery costs
  • Two doctor visits for mother after birth
  • Regular medical check-ups, immunizations and prescriptions for your baby

Visit our Benefits for Pregnant and New Moms page to learn about even more extra benefits!

Pharmacy

If you need help finding a pharmacy, visit our Find a Doctor page. If you have problems getting prescriptions filled or need more help finding a pharmacy, call member services at 1-855-921-6284 (TTY 7-1-1).

If you are taking a prescription for longer than 30 days, consider using the mail order pharmacy. It’s easy and saves money. Visit Navitus Health Solutions for more information.

The CHIP Pharmacy Program does not cover:

  • Over-the-counter drugs
  • Birth control medications needed only for birth control purposes
  • Nutritional products
  • Medical supplies or equipment, except for insulin syringes
  • Drugs that must be given in a doctor’s office or health-care facility

Behavioral Health and Substance Abuse

Members can get behavioral health help by calling 1-855-921-6284 (TTY 7-1-1). A list of mental health providers is available in the Find a Doctor section.

Vision

$100 for upgraded lenses and frames or contacts every two years

Dental

Up to $500 for checkup, x-rays, cleanings, fillings, and extractions each year for STAR members 21 and older and CHIP Perinate members 19 and older.

Transportation benefits

Nonemergency Medical Transportation (NEMT) services for STAR members.

You can get no-cost rides to your health-care services through your Medicaid benefits. Dell Children’s Health Plan will provide rides to the doctor, dentist, hospital, pharmacy, and any other place you receive Medicaid services.

Can I schedule a ride?

To schedule a ride through Dell Children’s Health Plan, you cannot have any other means of transportation. You must also be enrolled in Texas Medicaid. NEMT services do not include ambulance trips.

How do I schedule a ride?

You should request NEMT services as early as possible. Call us at least two working days before you need a ride within your service area. If you need to travel out of town, or out of your service area, call us at least five working days before you need a ride. You can request an NEMT service with less than 48 hours’ notice in certain situations such as:

  • Being picked up after being discharged from a hospital.
  • Trips to the pharmacy to pick up medication or approved medical supplies.
  • Trips for urgent conditions; an urgent condition is a health condition that is not an emergency but is severe or painful enough to need treatment within 24 hours.

To schedule a ride, please call 1-844-867-2742 (TTY 7-1-1).

Dell Children’s Health Plan will use Access2Care to arrange travel.

You can call Monday through Friday from 8 a.m. to 5 p.m. Central time, except for state-approved holidays. If you do not speak English, we can help you in many other languages, including Spanish.

“Where’s My Ride?”

When you are waiting on transportation from us, whether going or returning on a scheduled trip, you can call the NEMT Services line. Pick the “Where’s My Ride?” option to find out the status of your ride. You can call between 5 a.m. to 7 p.m. Central time Monday through Saturday or anytime you are waiting for a scheduled ride.

Use the Access2Care Mobile App

Find the app using a search for Access2Care or A2C. With the Access2Care mobile app, you can:

  • Schedule a new trip or view scheduled trips.
  • View trip details.
  • Cancel a trip.
  • Call Access2Care or the transportation provider.

* Access2Care is an independent company providing transportation services on behalf of Dell Children’s Health Plan. More information about Access2Care is available at access2care.net.

Value added benefits

Dell Children’s Health Plan gives you extra transportation benefits. We can help you get rides for:

  • Pregnancy or birthing classes
  • Women, Infants, and Children (WIC) offices
  • Food banks and grocery stores
  • Health Plan sponsored events
  • Member Advisory Group meetings

Call Member Services at 1-855-921-6284 (TTY 7-1-1) Monday through Friday from 8 a.m. to 6 p.m. Central time.

CHIP members

Dell Children’s Health Plan can help with rides to:

  • Doctor visits for members with chronic illnesses
  • Pregnancy or birthing classes
  • Women, Infants, and Children (WIC) offices
  • Food banks and grocery stores
  • Health Plan sponsored events
  • Member Advisory Group meetings

Call Member Services at 1-855-921-6284 (TTY 7-1-1) Monday through Friday from 8 a.m. to 6 p.m. Central time.

You can find specific benefit details, including exclusions and limitations, in your member handbook. You can view your member handbook for more information on how to use your benefits.

Questions?

We’re here to help. Call us at 1-855-921-6284 (TTY 7-1-1).

If you already have CHIP or STAR Medicaid, you can change your health plan at any time. Just call the CHIP/STAR Medicaid Helpline at 1-800-964-2777 and tell them you want to become a member of Dell Children’s Health Plan.