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Children's Health Insurance Program (CHIP)



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Welcome Blue Cross and Blue Shield of Texas Members

Blue Cross and Blue Shield of Texas (BCBSTX) is a health insurance provider that is a part of the Texas Medicaid program. We are pleased to provide a new health plan for people and families who qualify under Medicaid.


Starting March 1, 2012, BCBSTX will begin serving CHIP members in the Travis service area which includes these counties:

  • Bastrop
  • Burnet
  • Caldwell
  • Fayette
  • Hays
  • Lee
  • Travis
  • Williamson

 

CHIP Cost Sharing 


Benefit Reference Guide 


CHIP and CHIP Perinatal Member Handbook 





Our strong relationships with hospitals, doctors and pharmacies give you many choices.


You get all the health care you know today with CHIP, plus these services at no extra cost:

  • Extra help getting a ride: Help getting a ride to doctor visits for CHIP members who need a ride
  • 24/7 Nurseline: Get non-emergency help from a nurse any time on our free nurse line
  • Free baby safety car seat: Pregnant moms can get a free car seat by getting health care before the baby is born
  • Sports and camp physicals: Free physicals for children 18 and under who want to play sports or go to camps
  • Upgraded eyeglass frames: $75 credit each year for children to buy stylish eyeglass frames

 

When you choose BCBSTX for CHIP, you have access to programs and classes that can help you live healthier.


Our health care programs will help you take better care of yourself if you have:

  • Asthma
  • Diabetes
  • Heart Disease

 


As a BCBSTX CHIP member, you can find many network providers in Texas. You have a wide choice of primary care providers, specialists, hospitals, and pharmacies.


You can find a network provider or pharmacy with Provider Finder. You can also download the Provider Directory or Pharmacy Directory.



How to File a Complaint

If you have a complaint, please call us at 1-888-292-4480 (TTY 1-888-292-4485), to tell us about your problem. We will take action. If you are not satisfied with the result, we can help you file a complaint. We will send you a form to fill out and return to us. If you cannot fill out the form, we will help you.


You can also file a complaint in writing. To file a complaint write to:

Blue Cross and Blue Shield of Texas
Complaints and Appeals
P. O. Box 684249
Austin, Texas 78768


We will send you a letter within five business days of receiving your complaint. This letter will list the date your complaint was received. We will look at your complaint and we will send you a letter within 30 calendar days of receipt to let you know how your complaint was resolved.


If you are not happy with the results of your complaint, you can file a complaint appeal. To file a complaint appeal, submit a request in writing to:

Blue Cross and Blue Shield of Texas
Complaints and Appeals
P. O. Box 684249
Austin, Texas 78768


We will send you a letter within five days of receiving your complaint appeal to let you know your appeal was received. Your complaint will be reviewed by an Appeals Panel within 30 days of your request. You have the right to appear before the Appeals Panel to talk about your case. We will send you a letter to let you know the ruling made.


You can also file a complaint with the Texas Department of Insurance (TDI) by calling 1-800-252-3439, or by writing at:

Texas Department of Insurance
P.O. Box 149104
Austin, TX 78714-9104



How to File an Appeal

If you are not satisfied with the ruling to deny or limit a service you have the right to ask for an appeal.


To file an appeal, call us at 1-888-292-4480 (TTY 1-888-292-4485). We can help you file your request for an appeal. Your health-care provider, a friend, a relative, legal, or another spokesperson can also stand for you and ask for an appeal.


You can also send your appeal in writing to:

Blue Cross and Blue Shield of Texas
Complaints and Appeals
P. O. Box 684249
Austin, Texas 78768


We will send you a letter within five business days of receiving your appeal. This letter will list the date your appeal was received. If you made your appeal by mouth, this letter will also include an appeal form that must be completed, signed, and returned to BCBSTX. We will look at your appeal and we will send you a letter explaining our ruling within 30 days from the receipt.


If a ruling is needed right away because your child's life or health is in danger, you can file an expedited appeal. We will review and decide on an expedited appeal within one business day. We will let you know our ruling by phone.


If you disagree with our ruling, you have the right to seek another review of the denial by an independent review organization (IRO). An IRO is independent from BCBSTX and is selected by the Texas Department of Insurance. The IRO's decision is final.


You can call us to help you with the IRO process. Call us at 1-888-292-4480 (TTY 1-888-292-4485) or complete the form "Request for Review by an Independent Review Organization" and mail it to:

Blue Cross and Blue Shield of Texas
Complaints and Appeals
P. O. Box 684249
Austin, Texas 78768


If you need care for mental health or alcohol and drug use, you will get care through Magellan Health Services.


Behavioral health care does not need approval from your primary care physician (PCP). But you may want to talk to your PCP about the problem. Behavioral health care can mean:

  • Medically necessary care for the treatment of mental, emotional and chemical dependency disorders
  • Counseling services
  • Medication management
  • Substance use treatment

 

If you have behavioral health problems, call Magellan toll-free at 1-800-327-7390. Members with hearing or speech loss may call the Magellan TTY line at 1-800-735-2988.


Vision providers take care of your eyes. You do not need an OK from your PCP for vision care. Look in the Provider Directory to find a vision provider, or call Davis Vision at 1-888-588-4825. Services include:

  • An eye exam every 12 months
  • Glasses and contact lenses
  • New glasses or contacts if they are lost or broken
  • An enhanced benefit for fashion eyewear. Please see the Enhanced Eyewear for Kids section under Value Added Services.

 

Children may be able to have further eye tests and glasses as part of Texas Health Steps. To learn more, call Davis Vision at 1-888-588-4825. If you have hearing or speech loss, you may call the Davis Vision TTY line at 1-800-523-2847.



How do I get eye care services?

Call Davis Vision at 1-888-588-4825, or look in your Provider Directory for eye doctors in your area. Members with hearing or speech loss may call the Davis Vision TTY line at 1-800-523-2847.


If you have questions, call us at 1-888-292-4480.

Members with hearing or speech loss can call the TTY line at 1-888-292-4485.