Medical Assistance and Resources - A Guide to Medical Services at CPS
Non-emergency Medical Transportation
Non-emergency Medical Transportation is a Medicaid benefit through HHSC's Medical Transportation Program (MTP). Contracted Transportation Providers provide MTP eligible clients free rides to and from the doctor, dentist, or other Medicaid covered services (such as to a drug store) for Medicaid clients with no other means of transportation.
MTP is not a service through the STAR Health program. Caregivers may call the Transportation Provider in their region directly to arrange transportation by calling 1-855-687-4786 if they live in the Houston/Beaumont area; 1-855-687-3255 if they live in the Dallas/Ft. Worth area; or 1-877-MED-TRIP (1-877-633-8747) for all other areas of the state. More information is available at www.hhsc.state.tx.us/medicaid/mtp.
Personal Care Services
Personal Care Services (PCS) is a Medicaid benefit through the Texas Health Steps Comprehensive Care Program (CCP). PCS provides support to Medicaid eligible children and young adults, birth through 20 years of age, who require assistance with activities of daily living (ADLs), instrumental activities of daily living (IADLs), and health maintenance activities because of a physical, cognitive, or behavioral limitation related to a disability or chronic health condition.
ADLs are activities that children and young adults do on a daily basis to perform daily self-care (such as feeding, bathing dressing, grooming, and toileting). IADLs may include: cooking, laundering, housekeeping, and the application and maintenance of prosthetics and orthotics. Assistance with health related functions may include helping a child or young adult with the use of durable medical equipment (DME) or the use of adaptive or assistive devices. PCS does not cover assistance with ADLs, IADLs, or health-related functions that a typically developing child of the same chronological age could not safely and independently perform without adult supervision.
More information about the PCS program, call 1-888-276-0702.
Case Management for Children and Pregnant Women's Program
Case Management for Children and Pregnant Women's Program is a Medicaid benefit for Medicaid eligible children with a health condition/health risk, birth through 20 years of age and high-risk pregnant women of all ages. The Case Management for Children and Pregnant Women’s program will help them gain access to medical, social, educational and other health-related services. CPW is not a service through the STAR Health program. For more information about the Case Management for Children and Pregnant Women's program or to get a case manager, call 1-877-847-837 or visit https://www.dshs.state.tx.us/caseman.
CHIP | Children's Medicaid
Call toll-free 1-877-543-7669 (that’s 1-877-KIDS-NOW) or visit www.chipmedicaid.org. Texas families with uninsured children may be able to get health insurance through Children’s Medicaid or the Children’s Health Insurance Program (CHIP). CHIP is a health insurance program for children whose families have low incomes, but earn too much to receive Medicaid and do not have private health insurance. Both programs offer healthcare benefits, including regular checkups and dental care.
To qualify for CHIP or Children's Medicaid, a child must be age 18 or younger, a Texas resident and a U.S citizen or legal permanent resident. The citizenship or immigration status of the parents does not affect the children's eligibility and is not considered for eligibility determination.
Children's Medicaid is health coverage provided at no cost to the children of families who qualify. Coverage begins as soon as the application is approved.
CHIP is health insurance designed for families who earn too much money to qualify for Medicaid, yet cannot afford to buy private health insurance. CHIP enrollment fees and co-payments are based on the family’s income. Enrollment fees are $50 or less per family for each 12 month term of eligibility and most co-payments for doctor visits and prescription drugs range from $3 to $10.
CHIP Perinatal offers health services for unborn children of women who qualify. Texas residents who are pregnant, uninsured and not able to get Medicaid may be able to get CHIP perinatal benefits for their unborn child. Coverage starts before the child is born. Upon delivery, the child may qualify for an additional 12 months of Medicaid or CHIP coverage, depending on the family's income.
Medicaid Buy-In for Children
Medicaid Buy-In for Children can help pay medical bills for children with disabilities. This program helps families who need health insurance, but make too much money to get traditional Medicaid. Families “buy-in” to Medicaid by making a monthly payment (premium).
To be in the Medicaid Buy-In for Children program a child must be age 18 or younger, a Texas resident and a U.S citizen or legal permanent resident, and not be married. The child must meet the same rules for a disability that are used to get Supplemental Security Income (SSI).
For more information call 2-1-1 or 1-877-541-7905 or visit yourtexasbenefits.hhsc.texas.gov.
Health Insurance Premium Payment (HIPP)
The Texas Health Insurance Premium Payment (HIPP) program helps families pay health insurance payments. A family may be eligible for HIPP if anyone in the family gets Medicaid and someone in the family can get health insurance at work. With HIPP, family members with and without Medicaid might get private health insurance. Those with Medicaid can still get Medicaid services not covered by the private health insurance.
To learn more, call the HIPP Helpline toll-free at 1-800-440-0493 or visit www.gethipptexas.com.
Your Texas Benefits
The Your Texas Benefits website offers you easy and secure online access to Texas Health and Human Services Commission (HHSC) benefits including Medicaid, Food Stamps, Temporary Assistance for Needy Families (TANF), Children's Health Insurance (CHIP), nursing home care, and other services for people who are elderly or have disabilities. To apply for benefits and more information go to www.yourtexasbenefits.com.
Medicaid For Adopted Children
Children in foster care who are adopted by licensed families may be eligible for Medicaid coverage when the family and child meet certain requirements. If approved an adopted child may receive Medicaid coverage up to the age 18. These benefits may last to age 21 if the child is age 16 or older when the adoption assistance agreement is signed, and the child meets certain educational vocational requirements. The child's Medicaid will transition from Foster Care Medicaid to Traditional Medicaid. This means the child will no longer be a STAR Health Member. The transition from Foster Care Medicaid to Traditional Medicaid may take a few months to complete. More information is available on these pages:
Permanency Care Assistance (PCA)
Licensed kinship families that obtain Permanent Managing Conservatorship (PMC) of a child may receive PCA benefits for that child. These benefits can include Medicaid coverage for the child up to age 18. The benefits may last until age 21 if the child is age 16 or older when the Permanency Care Assistance (PCA) Agreement is signed, and the child meets certain educational/vocational requirements. The child's Medicaid will transition from Foster Care Medicaid to Traditional Medicaid. This means the child will no longer be a STAR Health Member. The transition from Foster Care Medicaid to Traditional Medicaid may take a few months to complete. More information is available at:
Children's Health Insurance Program (CHIP)
CHIP is a health insurance program for children under 19 years of age whose families have low incomes and resources, but earn too much to receive Medicaid and do not have private health insurance. If Medicaid is not in place and a child is currently in the process of applying for Supplemental Security Income (SSI) benefits, they should consider applying for the Children's Health Insurance program while the SSI application is being processed.
Additional Programs and Resources
More information is available at:
For additional resources see Medical Assistance & Resources for CPS Children & Families (above).
A brief overview of services available for youth transitioning out of foster care can be found in this document. The document describes state- and federally-funded programs for individuals currently or formerly in foster care. Many more resources can be found on the Texas Youth Connection, a website to help foster youth make their way towards independent, healthy, adult living.
Former Foster Care in Higher Education (FFCHE)
Effective October 1, 2009, the Health and Human Services Commission (HHSC) began providing health care benefits to certain former foster care youth who are at least 21 years or older, but younger than 23 years of age, who are eligible to receive assistance as an independent foster youth and who are enrolled in an institution of higher learning. To request the FFCHE application individuals must call the DHS Centralized Benefits Section at 1-800-248-1078, ext. 9658 or 2-1-1. [FFCHE Fact Sheet]
Additional Programs & Resources
- Transitional Living Services: A Brief Overview
- FFCHE Fact Sheet
- Texas Youth Connection
- Health & Human Services Commission
- Apply for CHIP Medicaid
- Health Care for Children
For additional resources see Medical Assistance & Resources for CPS Children & Families (above).
- Superior Health Plan
- Diabetes information booklets: A Fresh View on Diabetes, It’s All about Diabetes, Una Nueva Mirada a la Diabetes, and Temas Básicos Sobre Diabetes.
- Joslin Diabetes Center, Harvard Medical School Affiliate
- Texas Health Steps
- TMF, Health for Life- Everyone with Diabetes Counts
- American Diabetes Association – Diabetes Basics
- American Diabetes Association – Discrimination Webinars