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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 Ingiriisi 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 KidsTallaabooyinka Isdiiwaangelinta
  • Hubi u-qalmida (ku furma bogga xiran)

Need help finding a provider or setting up a visit?

Ka wac Adeegyada Xubinta (Member Services) lambarka 1-877-597-7799, TTY 7-1-1, Isniinta-Jimcaha 8 sn.-5 gn. ama iimayl u dir memberservices_uhccp@uhc.com si ay kaaga caawiyaan inaad hesho daryeel bixiye ama aad uga qabsato ballan booqasho.

Macaashyada & Sifooyinka

Daryeelka Dadka Caafimaadka Qaba iyo Dadka Jirran

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. Tani waxaa ka mid ah:

  • 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. Dheefooyinka waxaa ka mdi ah:

  • 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. Tests, checkups and hearing aids, if needed, are provided.
  • 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. Dheefooyinka waxaa ka mdi ah:

  • Personal Care. Someone to help with dressing, bathing and dining.
  • Equipment and Supplies. In-home medical and safety equipment are covered.
  • Respite Care. In-home help to give your caregiver a rest.

Sometimes you might need a little extra help using your child's health plan. For those times, you can rely on:

  • 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 Ingiriisi | 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.
  • Vision and dental. Have regular eye and dental exams. We cover glasses and contact lenses too.
  • 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.

Maareynta Kiiska

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.

Dooqa dhakhtarka

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.

PCP-gaaga ayaa ah dhakhtarkaaga ugu muhiimsan ee loogu tala galay:

  • Preventive care.
  • Treatment if your child is sick or injured.
  • Referrals to specialists for certain conditions.

Daryeelka ilkaha

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.

Qalabka iyo Saadka

Our plan covers medical equipment ordered by your doctor or case manager. Tani waxaa ka mid ah:

  • 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.

Isbitaal Dhigista

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

Tani waxaa ka mid ah:

  • Nursing care.
  • Room and board.
  • Supplies and equipment.
  • Treatment and therapies.
  • Diagnostic tests and exams.

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

Interpreters

Your child's doctor and you need to understand each other. In aan si fiican loo hadlin Ingiriisi ayaa tan ka dhigaysa mid adag. 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.

Ka caawin Luqad

You can ask to receive information in another language. Then anything we write to you will only be in that language. This is provided at no cost to you.

Daawooyinka

We make getting your child's medicine easy.

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.

Member Services

Sometimes you might need a little help understanding your child's health care options. With us, you have someone you can call 24/7. We'll answer your questions simply and completely.

We can also help you find:

  • Home care providers.
  • Dentists and vision providers.

Caafimaadka Maskaxda

Mental health is as important as physical health. Taasi waa sababta aan u leenahay caymis isku mid ah labadaba.

Daryeelka loo baahan yahay waxaa la daboolay 100% iyadoo la isla bixinayn. Tani waxaa ka mid ah:

  • Behavioral therapy.
  • Daawooyinka.

You pay nothing for covered services.

No Copays

While your health care is low-cost or free, the care quality is high. You get:

  • 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.

Khadka Taleefanka Kalkaaliyaha

Medical questions and situations come at inconvenient times. 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:

  • Listen to the symptoms.
  • Guide you on self-care.
  • Kaala talin doonaan ku helida daryeel booqashada dhakhtarka ama xarunta daryeelka degdegga ah.
  • Suggest you go right to the emergency department.

Personal Visits

If needed, we provide someone to help with:

  • Dressing.
  • Bathing.
  • Feeding.

Respite Care

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.

Service Coordinator

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.
  • Behavioral health services.
  • 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.

Gaadiid-raaca

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.

Daryeelka Aragga

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.

Dhigaalada Xubinta

Ilaha Xubinta (fur daaqada modeelka)

Macluumaadka diiwaangelinta

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

Naga soo wac:
1-877-597-7799 / TTY: 711

8:00 sn. ilaa 5:00 gn. wakhtiga maxaliga ah, 7 maalmood todobaadkii

Tallaabooyinka Isdiiwaangelinta
Get the details

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.

Macluumaadka Xubinta

Horay ma u ahayd xubin? Waxaad geli kartaa mareegtayada xubinta loogu talagalay. Print ID cards, chat with a nurse online, and more. 

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

Mareegta Xubinta

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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