• Helpful Medicaid & CHIP Phone Numbers for Clients
• A Consumer Guide to Better Health Care - Your Guide to Understanding the Health Care System in Texas
• How do I apply for Medicaid?
• How do I check the status of my Medicaid application?
• What are the different types of Medicaid and how do I use my Medicaid?
• What if I'm denied a Medicaid service?
• What do I do if I'm billed for Medical services while on Medicaid?
• Prescription Assistance
• Medicare Prescription Drug Coverage

How do I apply for Medicaid?

There are several ways to apply for Medicaid:

1. You can apply at your local HHSC office. Click here to find the HHSC office nearest you.


2. For children's benefits you can download a Children's Medicaid/CHIP application here. You can apply over the phone, by fax or by mail.


3. If you live in Travis or Hays Counties, you can apply at www.yourtexasbenefits.com OR you can dial 211 from your home phone to apply with a representative over the phone.


4. If you have a DISABILITY and you do not qualify for Medicaid through the Texas Health & Human Services Commission you may qualify for Supplemental Security Income (SSI) which will automatically qualify you for SSI Medicaid. Click here to find out more information about applying for SSI.

If you would like more general information about Medicaid Eligibility and applying for Medicaid, click here.

How do I check the status of my Medicaid application?

1. If you live in Travis or Hays counties and applied for any benefits, call 2-1-1 to find out the status of your application. You may also check your application by visiting this website: www.yourtexasbenefits.com


2. If you applied for Medicaid, Foodstamps or TANF for an adult or for your whole family, contact your local HHSC office to find out the status of your application. Click here to find the HHSC office nearest you.
3. If you sent a NEW application (applying for the first time) for CHIP or Children's Medicaid, call the CHIP/Children's Medicaid Hotline at 1-800-647-6558 to find out the status of your application. They can also give you information about the status of your child's CHIP renewal.
4. If you need information about your child's Medicaid renewal application and you live in one of the following metropolitan areas, you can contact your Children's Medicaid Unit to check on the status. If you don't see your county listed below contact your local HHSC office:

What are the different types of Medicaid and how do I use my Medicaid?

Depending on the kind of Medicaid you have and where you live, you may have to follow certain rules to use your Medicaid. There are 4 different Medicaid "programs":

STAR

Texas STAR is one of the Texas Medicaid managed care programs. It is only available in the major Texas cities and surrounding areas. If you are on STAR, you will see a logo on your monthly Medicaid ID form.

Who can enroll with STAR?
What do I need to know about my Medicaid ID form?
How do I choose a health plan and doctor?
How does the STAR program work for pregnant women?
What if I don't pick a health plan or doctor?
What are my rights in the STAR program?
What are my responsibilities in the STAR program?
How do I file a complaint or appeal with my health plan?
Click here for tips on filing a complaint or preparing for an appeal.
What if I've moved and there is no STAR or PCCM where I live now?


STAR+PLUS

What is STAR+PLUS?
Who qualifies for STAR+PLUS?

Where is STAR+PLUS offered?
STAR+PLUS currently only serves clients in Harris county. On January 1, 2007 STAR+PLUS will expand to the Bexar, Harris/Harris Expansion, Nueces, and Travis Service Areas. To see a map of the STAR+PLUS service areas and the health plans that will be providing services click here.

Primary Care Case Management (PCCM)

PCCM is another Texas Medicaid managed care program. It is available in the rural parts of Texas. If you are on PCCM, you will see a logo on your monthly Medicaid ID form.

What is PCCM?
For a list of PCCM counties click here
PCCM Member Handbook - English
PCCM Information for Clients
What if I've moved and there is no STAR or PCCM where I live now?
PCCM Providers


Traditional Medicaid

Traditional Medicaid is only for certain people. If you have traditional Medicaid, and need to find a doctor in your area, call the Medicaid Hotline at 1-800-252-8263.

What if I'm denied a Medicaid service?

How do I file an appeal with the state?
How do I file a complaint or appeal with my health plan?

Prescription Assistance

For many adults, Medicaid in Texas only pays for three prescriptions per month. Here are some ideas to help with your prescriptions:

1. Always talk to your doctor about your medicines. If they know you can't afford to fill all of your prescriptions they may be able to help you find a solution.


2. Ask your doctor if you can get a longer supply of the medicines you take. Medicaid will pay for up to a 90 day supply of each medicine as long as your doctor approves.


3. Always get Medicaid to pay for the 3 most expensive medicines. That way if you have to pay for some of your medicines you will be paying for the cheaper ones.


4. Shop around to different pharmacies. Not all pharmacies charge the same price for the same medicine. You might be able to find your medicines cheaper somewhere else.


5. Call 2-1-1 from your home phone. They will be able to tell you if there are any local programs in your area that can help pay for your medicines.


6. Call Partnership for Prescriptions at 1-888-477-2669.

If you don't qualify for Medicaid there are some prescription drug discount cards you may qualify for. Here is a list of the drug manufacturer-sponsored drug discount cards.

Medicare Prescription Drug Coverage

On January 1, 2006 Medicare began offering prescription drug coverage to everyone on Medicare. This includes people who have both Medicaid and Medicare. Drug coverage is provided through private drug plans. All plans are required to offer the same basic coverage but some plans may offer more coverage for a higher monthly premium. People with both Medicaid and Medicare can change drug plans at any time.

If you have limited income and resources, you may be able to get extra help to pay for your monthly premiums, deductibles and co-payments under this prescription drug program. The amount of extra help depends on your income and resources.

If you have both Medicaid with prescription drug coverage and Medicare, Medicare and Supplemental Security Income, or if your state pays for your Medicare premiums, you automatically will get this extra help. You do not have to do anything.

** If you have more questions about your Medicare Coverage, call the Medicare Hotline at 1-800-633-4227.

NOTE: Some of these fact sheets may take a few minutes to download.

Quick Facts about Medicare Prescription Drugs for SSI Clients
More information for people who get Supplemental Security Income benefits or help from their state Medicaid program paying their Medicare premiums.

For more information about the Medicare Prescription Drug Program go to:
http://www.cms.hhs.gov/medicarereform/factsheets.asp

Quick Facts about Medicare's New Coverage for Drugs

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