Forms and Documents

These forms and documents are available as PDF files. Just click on a form or document to download it. You will need Adobe Reader to view these files; this can be downloaded free of charge at Adobe's site .

Handbook and Directories

STAR Member Handbook
STAR Member Handbook Addendum (4/1/2019)
Provider Directory
Pharmacy Directory
Drug List (Formulary)
Dental Provider Directory (adult STAR members only)
Benefit Resource Guide

Forms

Prenatal Incentive Options (Car Seat or Pack and Play) Form
Appeal Request Form
Complaint Form
Fair Hearing Request Form
Primary Care Provider (PCP) Selection Form
Request to Access PHI Form
Text and Email Messages Permission Form

Value Added Services and Program Brochure

Value-Added Services Brochure
Logisticare Transportation Brochure
STAR Care Coordination Brochure
Farmworkers Brochure
Special Beginnings Brochure
Medicaid STAR and CHIP Resource Guide
Value-Added Dental Services

Important Notices

Annual Notices and CAHPS Survey Results
Preventive Health Guidelines*
HIPAA Notice of Privacy Practices
Your Rights for an Appeal of an Adverse Determination

Find additional prescription drug forms here.

Additional Resources

Texas Health and Human Services Commission
Texas Department of State Health Services
Texas Department of Family and Protective Services
Texas Department of State Health Services, Women, Infants, and Children Program (WIC)
Texas Juvenile Justice Department
Children Advocacy Centers of Texas, Inc.
Your Texas Benefits, from the Texas Health and Human Services Commission
Healthy Texas Women

* In addition to the preventive health guidelines, clinical guidelines are available upon request. Call customer service at 1-888-657-6061 (TTY 711) to request a copy.
 

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Contact Us

  • 1-888-657-6061 (TTY 711)
  • 8 a.m. to 8 p.m. Central Time Monday through Friday
  • Contact Us