Dell Children’s Health Plan (formerly Seton Health Plan) covers families in Central Texas who don’t have their own health insurance through healthcare coverage in the CHIP and STAR programs. As a member of Dell Children’s Health Plan, you can count on the best care possible from Central Texas’s leader in pediatric medicine. Dell Children’s Health Plan has been an administrator of CHIP (The Children’s Health Insurance Program) since 2000 and in March of 2012, Dell Children’s Health Plan, Inc. was selected to administer the CHIP Perinate and STAR (Medicaid) programs in Central Texas.
Dell Children Health Plan serves the following counties:
What is CHIP and STAR?
|What is it?||The Children’s Health Insurance Program (CHIP) or Children’s Medicaid is for those who do not qualify for Medicaid, but cannot afford private health insurance.||STAR is managed care Medicaid. A medical plan that provides Medicaid services and a main doctor that is the point of contact for Medicaid services is picked . In addition to the main doctor, each plan has a large group of specialists, therapists, clinics, and hospitals that can provide Medicaid services.|
|What does it cover?||• Dentist visits, cleanings, and fillings|
• Eye exams and glasses
• Choice of doctors, regular
checkups, and office visits
• Prescription drugs and vaccines
• Access to medical specialists and
mental health care
• Hospital care and services
• Medical supplies, X-rays, and lab
• Treatment of special health needs
• Treatment of pre-existing
|The STAR program gives all of the benefits Medicaid has to offer.|
• No limit on the number of days in a hospital
for needed care.
• No limit on the number of medicines.
• Health education classes.
• Medical plans that offer extra services not
covered by Medicaid. These are called
|What does it cost?||Enrollment fee and co-pays will be based on the family’s income. Enrollment fees are $50 or less per family, per year. Co-pays for doctor visits and prescriptions range from $3 to $5 for lower-income families and $20 to $35 for higher-income families.||Medicaid families do not have to copay.|
|How to get it||To qualify, a child must be:|
• Age 18 or younger (up to age 20 can qualify for Medicaid in
• A Texas resident.
• A U.S. citizen or legal permanent
resident. (parents’ legal status does not matter)
|One must enroll in the STAR program if|
approved for Medicaid and any of the
• You get cash assistance (Temporary Assistance
for Needy Families - TANF)
• You are pregnant
• You or your children have limited income
• You are a newborn baby
CHIP Coverage for Unborn Children
If you are pregnant, a Texas resident, you don’t have insurance, and you cannot get Medicaid, you may be able to get perinatal coverage from CHIP. This coverage is for your unborn baby. It covers your labor with delivery and your baby’s health and medical services for its first months of life.
Medicaid for Pregnant Women
A pregnant woman with little or no income can receive Medicaid benefits during pregnancy and up to two months after birth if she meets certain income requirements.
For more information about any of our services, please call Member Services at 888-596-0268.
Members can get free oral interpretation services and information in other formats, like Braille, audio, or large print. Call Member Services toll free at 888-596-0268 TTY 711