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Pangunahing Nilalaman

STAR Kids

Medicaid

At UnitedHealthcare Community Plan, we understand that the health care system can be complex and confusing. We know it can be especially stressful when your health care plan changes. UnitedHealthcare Community Plan will be with you every step of the way.

We want to make sure our members have access to the quality care they need and deserve. Our large network includes the doctors you already know and trust. That’s what you can count on with UnitedHealthcare Community Plan. View the list below to see what STAR Kids includes.

Language and Interpreter Services

UnitedHealthcare Community Plan has staff that speaks Ingles and Spanish. If you speak another language or are hearing impaired and need help, call Member Services at 1-877-597-7799 or TTY 711 for hearing impaired.

If you need materials in audio, Braille, larger print and in other languages at your request. Please call 1-877-597-7799 for help.

  • STAR Kids Steps to Enroll
  • Tingnan ang Eligibility (magbubukas ng modal window)

Need help finding a provider or setting up a visit?

Tumawag sa Mga Serbisyo sa Miyembro sa 1-877-597-7799, TTY 7-1-1, Lunes-Biyernes 8 AM-5 PM o mag-email sa memberservices_uhccp@uhc.com para makakuha ng tulong sa paghahanap ng tagapagbigay ng serbisyo o makapagtakda ng pagbisita.

Mga Benepisyo at Feature

Pangangalaga Habang Walang Sakit at Kapag May Sakit

Get the assistance you need to stay healthy — or to get better if you are injured or sick. And pregnant moms get extra support to keep you and your baby healthy. Kasama rito:

  • Hospital Care. You pay nothing for care in a hospital.
  • Lab and X-rays. Lab tests, x-rays and diagnostic imaging are covered.
  • Transportation. We pay for rides to and from medical visits or pharmacy.
  • Well Visits. Annual checkups can help keep you healthy.

If your child has asthma, diabetes or another long-term condition, you can depend on us. The STAR Kids Plan makes sure your child gets the care and services he or she needs. Kabilang sa mga benepisyo ang:

  • Case Management. Personal support from an experienced professional.
  • Asthma Support. Individual care to help control asthma or COPD.
  • Mental Health. Counseling and other treatments are available.

Help protect your child’s sight, hearing and smile with these benefits:

  • Vision. Includes exams and $105 toward frames or contact lenses.
  • Hearing. Ang mga pagsusuri, checkup at hearing aid, kung kailangan, ay ibinibigay.
  • Dental. Most children and young adults age 20 and younger with Medicaid or CHIP coverage get dental services through a managed care dental plan. The dental plans listed below provide services across the state for all Medicaid and CHIP members who qualify for dental coverage. 
    • DentaQuest
    • UnitedHealthcare Dental

Get the medical equipment, assistance and supplies you need to live safely at home. Kabilang sa mga benepisyo ang:

  • Personal Care. Someone to help with dressing, bathing and dining.
  • Equipment and Supplies. In-home medical and safety equipment are covered.
  • Pansamantalang pangangalaga. Tulong sa tahanan upang makapagpahinga ang iyong caregiver.

Sometimes you might need a little extra help using your child's health plan. Para sa mga pagkakataong iyon, maaari kang umasa sa:

  • Transportation. We offer rides to and from medical visits or the pharmacy.
  • Interpreters. An interpreter can go with you to medical visits.
  • Language Help. Translated medical materials are available at no cost.
  • Member Services. Your benefit questions are answered 24/7.

Read about all the extras your child could get as a STAR Kids member:

  • Exercise Kit. Includes one pedometer, one pack of resistance bands, and one water bottle for members who want to become more active. 
  • Online Mental Health Resources. Access articles, videos, and other resources at LiveandWorkWell.com 
  • Healthy First Steps®. Pregnant members who enroll in Healthy First Steps Babyscripts will receive access to free educational content, resources, and rewards for going to prenatal and postpartum visits.
  • Extra Benefits. Sports and school physicals offered at no cost

Learn more about Value-added Services Ingles | Español

If your child or young adult is disabled or living with an illness, your child’s health needs are unique. Our job is to make it as easy as possible for you to meet those needs. We make sure you get all your Medicaid benefits and more.

  • Choice of Doctor. Find a primary doctor in your neighborhood. Your doctor can send you to thousands of specialists too.
  • Nurse HotlineSM. Your caregiver can call our nurses for advice 24/7.
  • Medicines. Get the medicine you need at a pharmacy near you or by mail order.
  • Paningin at dental. Magkaroon ng mga regular na pagsusuri sa mata at ngipin. Sinasaklaw rin namin ang mga salamin at contact lens.
  • Mental Health. Counseling and other treatments are covered.
  • Service Coordinator. Someone to help you manage complex health conditions.
  • Transportation. We pay for rides to and from medical visits or the pharmacy.
  • Value-added benefits. Earn free gift cards when you take healthy steps. You’ll get rewards for yearly wellness exams, along with other benefits.

Our STAR Kids Plan is for persons on the HCBS waivers CLASS, HCS, TxHML, DBMD and in ICF-IDD facilities. Learn more here

Asthma and COPD Care

One hypoallergenic mattress cover and one hypoallergenic pillowcase for qualifying members with a diagnosis of severe asthma.

Pamamahala ng Kaso

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 doctor appointments.
  • Provide your care team with your medical records.

Your case manager will stay with you on your child's medical journey. He or she will:

  • Think beyond your medical needs.
  • Make sure you have support at home.

So you can focus on helping your child get better.

Pagpili ng Doktor

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 their doctor is not in our network, we can help you find a new one close to you.

Ang iyong PCP ay ang iyong pangunahing doktor para sa:

  • Preventive care.
  • Treatment if your child is sick or injured.
  • Mga referral sa mga espesyalista para sa ilang partikular na kondisyon.

Pangangalaga sa Ngipin

Checkups, routine and emergency care are covered.

Exams and cleanings every six months help keep teeth and gums strong and healthy. If there is a dental problem that needs to be fixed, that's covered as well.

Mga Kagamitan at Supply

Sakop ng aming plano ang medikal na kagamitang ibinilin ng iyong doktor o case manager. Kasama rito ang:

  • 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.

Pagkakaospital

This plan pays for all expenses related to a hospital stay, so your child can rest and heal.

Kasama rito ang:

  • Pangangalaga ng isang nurse.
  • Kuwarto at matutuluyan.
  • Mga supply at kagamitan.
  • Paggagamot at mga therapy.
  • Mga diagnostic na test at eksaminasyon.

After your child leaves the hospital, you are not alone. We make sure your child gets follow-up care to continue healing at home.

Mga interpreter

Your child's doctor and you need to understand each other. Magiging mahirap ito kung hindi ka magaling magsalita ng Ingles. 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.

Tulong sa Wika

You can ask to receive information in another language. Then anything we write to you will only be in that language. Ibinibigay ito sa iyo nang walang bayad.

Mga Gamot

Pinapadali namin ang pagkuha sa gamot ng iyong anak.

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 child's doctor.

Mga Serbisyo para sa Miyembro

Sometimes you might need a little help understanding your child's health care options. With us, you have someone you can call 24/7. Sasagutin namin ang iyong mga tanong sa simple at kumpletong paraan.

Maaari ka rin naming tulungang humanap ng:

  • Mga provider ng pangangalagang pantahanan.
  • Dentists and vision providers.

Mental Health

Ang mental health ay kasinghalaga ng physical health. Kaya mayroon kaming parehong saklaw para sa dalawang ito.

Ang kinakailangang pangangalaga ay 100% sinasaklaw nang walang copay. Kasama rito ang:

  • Behavioral therapy.
  • Mga gamot.

Wala kang babayaran para sa mga sinasaklaw na serbisyo.

No Copays

While your health care is low-cost or free, the care quality is high. Magkakaroon ka ng:

  • Care from highly skilled and compassionate doctors.
  • Treatments at respected hospitals and clinics.
  • Home medical equipment and supplies to help your child be at his or her best.

Hotline ng Nars

Dumarating ang mga medikal na tanong at sitwasyon sa mga hindi magandang pagkakataon. When you have questions about your health or your child's health, you can call a trained nurse 24 hours a day, 7 days a week.

Our Nurse Hotline nurses will:

  • Tutukuyin ang mga sintomas.
  • Gagabayan ka sa pangangalaga sa sarili.
  • Papayuhan ka tungkol sa pagkuha ng pangangalaga sa pagpapatingin sa isang doktor o sa isang center ng agarang pangangalaga.
  • Suggest you go right to the emergency department.

Personal Visits

Kung kinakailangan, magpapadala kami ng tao para tumulong sa:

  • Pagbibihis.
  • Pagligo.
  • Pagpapakain.

Respite na Pangangalaga

We provide respite care to give caregivers a rest. Respite care offers caregivers time away from their loved one who has special care needs to run errands or just relax.

Coordinator ng Serbisyo

Every STAR Kids member gets a service coordinator. Your child’s service coordinator will visit with your family in person to go over your child’s health care needs. At these visits you will talk about the services your child is getting and other services your child may need. 

Together you will create a care plan that works best for your family. Your care plan may include:

  • Acute medical services.
  • Mga serbisyo sa kalusugan ng pag-uugali.
  • Primary care services.
  • Special care services.
  • Value-added services.

Your service coordinator can also help you.

  • Arrange care with your primary care provider and with specialists.
  • Connect your family with community programs and additional services.
  • Answer questions about benefits.
  • Help coordinate benefits with other providers.

Transition Specialist

What is a Transition Specialist? What will a Transition Specialist do for me?

For children with special health care needs, the transition to adulthood often brings many changes. A Transition Specialist can help you understand and plan for these changes. All STAR Kids members have access to a Transition Specialist.

How can I talk to a Transition Specialist?

If you want to speak with a Transition Specialist or have a Transition Specialist as part of your Care Team, let your Service Coordinator know and he or she can help you.

Transportasyon

Whether you live in the city or in the country, rides are available. Our plan provides up to 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.

Pangangalaga sa Paningin

Your child can get the care, eyeglasses and treatment that lets him or her see life more clearly. Coverage includes $105 each year toward frames or contact lenses.

This benefit is offered by certain stores and retailers.

Mga Resource ng Miyembro

Mga Mapagkukunan ng Miyembro (magbubukas ng modal na window)

Impormasyon sa Enrollment

The Texas STAR Kids plan specialists can answer questions and help you enroll.

Tawagan kami:
1-877-597-7799 / TTY: 711

8:00 AM hanggang 5:00 PM lokal na oras, 7 araw sa isang linggo

Mga Hakbang para Mag-enroll
Kunin ang mga detalye

Visit the Texas CHIP & Medicaid site for more information on eligibility and enrollment.

Texas STAR Kids

For information in alternate formats, like large print, Braille or audio, please call Member Services.

Impormasyon ng Miyembro

Miyembro na? Mayroon kang access sa aming website na para lang sa miyembro. Mag-print ng mga ID card, makipag-chat sa isang nurse online at higit pa. 

Member information is available in paper form, at no cost, upon request, and sent by the health plan within five business days.

Website ng miyembro

At UnitedHealthcare we want to make sure you can access all the benefits your plan provides.

If you’ve had a change in your health status and your doctor determines you need a wheelchair, your plan is here for you.

To make sure you get the equipment you need with the coverage you have, follow these simple steps.

You may need a wheelchair evaluation referral from a healthcare provider in your plan’s network for wheelchairs with special features.

Next a Durable Medical Equipment or DME vendor in your health plan network is located.

In many cases, your healthcare provider can help locate an in-network provider and send the referral.

If the health care provider does not complete this step we can help you find an in-network provider and schedule an appointment.

It is important to understand what your insurance does and does not cover, so that you don’t have unexpected expenses.

And we can help you with that.

Once the referral has been sent to the identified provider the evaluation will be performed by a physical therapist, an occupational therapist or a physiatrist who specializes in determining proper seating and positioning.

This evaluation may take place in your home or in the DME provider’s office.

If the assessment takes place at the provider office, be sure to bring your wheelchair with you if you have one.

During the visit you may be asked to provide additional information including your health status and risk factors, transportation needs, and information on your home environment (if the assessment does not take place in your home).

Wheelchairs may take anywhere from 60 to 90 calendar days to be delivered.

Factors such as supply chain issues and availability of parts may cause additional delay.

Your DME provider can assist you with a loaner chair during the waiting period if needed.

When your new wheelchair is delivered be sure to sit in it to ensure proper fit and adjustments.

And even if you have experience with wheelchairs do take the time for the vendor to provide instructions on the use of the chair and its features, care and maintenance.

If any equipment you are requesting is not a covered benefit you may be asked to pay out of pocket for the equipment.

The vendor should provide you with a clear explanation of why it is not part of your benefits.

Generally, a wheelchair should last at least five years, although growing children may need a new chair more often.

If you already use a wheelchair and it’s damaged and unable to be repaired you may also be eligible for a new wheelchair.

Over time your insurance and DME providers may change.

So, be sure and keep all the information about the chair, the DME provider, the coverage and any documentation on any repairs or changes made.

Remember, if you have any questions or need more information visit https://member.uhc.com/communityplan or call member services at the number on the back of your member ID card.

 

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