How Your Plan Works

Once you send your application to the Health and Human Services Commission (HHSC), they will process it and let you know if you qualify for CHIP or (STAR) Children’s Medicaid.

Make sure you choose a Primary Care Provider (PCP) who accepts Dell Children’s Health Plan CHIP/STAR Medicaid. Click on Find a Doctor or click here for the CHIP Provider Directory, CHIP Perinatal Provider Directory, or STAR Provider Directory. Call Member Services at 1-855-921-6284 to have a provider directory mailed to you at no cost.

You should always be able to reach your PCP 24/7 by calling your doctor’s office number. If the office is closed, you may be sent to an answering service. They will know how to reach the doctor or ask you to leave a phone number so the doctor can call you back. Dell Children’s Health Plan also offers a 24-hour nurse hotline. You can reach them at 1-855-712-6700.

Remember that you can change your PCP at any time. Call Dell Children’s Health Plan Member Services at 1-855-921-6284 to make the change. Member Services can tell you when you can go to your new PCP.

You may not get to change your PCP if:

  • The new PCP is not in the Dell Children’s Health Plan network, or
  • The new PCP is not taking new patients

Referrals to Specialists

Sometimes your primary care provider will need you to see a specialist or another provider for care or services he or she can’t provide. This is called a referral. Your doctor may also need us to approve certain services before you get them. This is called prior authorization.

As of April 1, 2014 referrals from you or your child’s PCP are no longer needed for Dell Children’s Health Plan CHIP and/or STAR members.

You can get OB/GYN, family planning, and behavioral health services without a referral from your doctor. This is called self-referral. To get these services, make an appointment with a doctor in our network. You can find a list of doctors using the Find a Doctor search tool.

We can also provide a member handbook in:

  • Audio
  • Large print
  • Braille
  • A language other than English or Spanish

Please contact Member Services at 1-855-921-6284 (TTY 7-1-1).

Both CHIP and STAR coverage lasts for a year.

Near the end of your coverage, you will receive an application for renewal. Complete it and return it as soon as possible. HHSC will process your renewal application. If you are having problems, we are also here to help you through the renewal process. Give us a call at 1-855-921-6284.