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Children's Health Insurance Program (CHIP)

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CHIP

Not all Texas CHIP plans are alike. With ours, your child gets extras that other plans don’t offer. View the list of benefits below to see all that our plan covers. It’s for children and young adults up to age 20, and pregnant women who don’t qualify for Medicaid. We also offer additional services called Value Added Services (VAS). View the list below to see what CHIP includes.

  • Children's Health Insurance Program (CHIP) Steps to Enroll
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Find providers and coverage for this plan.

Find a Doctor

Search for doctors, hospitals and specialists.

View Drug List

Find medications covered by this plan.

Find a Pharmacy

Find a pharmacy near you.

Need help finding a provider or setting up a visit?

Call Member Services at 1-888-887-9003, TTY 7-1-1, Monday-Friday 8 a.m.-8 p.m. or email memberservices_uhccp@uhc.com to get help finding a provider or setting up a visit.

Benefits & Features

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Well and Sick Care

Get the assistance your child needs to grow up healthy — or to get better if he or she is injured or sick. That includes:

  • Medicines. Fill your child's prescriptions at local pharmacies.
  • Vision. Includes your child's exams and $105 toward frames or lenses.
  • Vaccines and Immunizations. Routine shots to help keep your child healthy.

Nothing is more important than the health and well-being of you and your baby. That's why our CHIP benefits for pregnant moms include:

  • Prenatal Visits. Care for you before your baby is born.
  • Choose a Birth Center. Deliver at your choice of hundreds of hospitals across Texas.
  • Healthy First Steps®. Get extra support and rewards to keep you and your baby healthy.
  • Infant Care Book. Helpful advice about newborns for expecting moms.

If your child has a special health care need, you can count on us. Our CHIP plan will provide the extra care and services he or she needs. Benefits include:

  • Case Manager. Personal support from an experienced professional.
  • Asthma Care. Exams, testing and supplies are covered.
  • 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. Screenings and therapies, if needed, are provided.
  • Dental. Checkups, routine and emergency care are covered.

Get medical equipment and supplies to manage your child's health. Benefits include:

  • Personal Care. Someone to help you with your child's in-home care.
  • Equipment and Supplies. Your child's in-home medical safety equipment is covered.

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

  • Transportation. We pay for rides to and from medical visits or the pharmacy.
  • Interpreters. Interpreters can be at children's medical visits.
  • Language Help. Translated medical materials are available at no cost.
  • Member Services. Call 24/7 for answers about your child's benefits.

Read about all the extras your child could get with our CHIP plan:

  • Exercise Kit. Includes one pedometer, one pack of resistance bands, and one water bottle for members who want to become more active. 
  • 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.
  • Vision. Includes exams and $105 toward frames or contact lenses.
  • Online Mental Health Resources. Access articles, videos, and other resources at LiveandWorkWell.com
  • Extra Benefits. Sports and school physicals offered at no cost.

Learn more about Value-added Services English | Español

Asthma and COPD Support

Individual care to help control your child's asthma.

Does your child have trouble managing asthma or COPD symptoms? A nurse who specializes in breathing issues can really help. Your child will get a customized treatment plan and medicine to:

  • Manage flare-ups.
  • Reduce symptoms.
  • Let your child stay active.

Case Management

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 child's doctor appointments.
  • Provide your care team with your child's medical records.

Your case manager will stay with your child throughout the medical journey. He or she will:

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

So you can focus on helping your child get better.

Choice of Doctor

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

Your child’s PCP is his or her main doctor for:

  • Preventive care.
  • Treatment for injuries or sickness.
  • Referrals to specialists for certain conditions.

Choose a Birth Center

Where to deliver your child is an important choice. That's why you can pick from hundreds of hospitals across Texas.

We encourage you to tour the hospital's birthing center. This way you will be familiar with it. And you'll be more relaxed when you deliver your baby.

Dental Care

Checkups, routine and emergency care are covered.

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

Equipment and Supplies

Your child's health and safety at home are important.

Our plan covers medical equipment ordered by your child's doctor or case manager. This includes:

  • 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.

Healthy First Steps®

Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up. 

We will help you:

  • Choose a pregnancy provider and a pediatrician (child’s doctor).
  • Schedule visits and exams and arrange rides to your visits.
  • Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
  • Get supplies, including breast pumps for nursing moms.
  • Connect with community resources such as Women, Infants and Children (WIC) services.

Hospitalization

This plan pays for all your child's expenses related to a hospital stay.

This includes:

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

After your child leaves the hospital, we watch over his or her care. 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. Not speaking English well makes this difficult. 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.

Language Help

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

Medicines

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 doctor.

Member Services

Sometimes you might need a little help understanding your 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.
  • Adult day health centers.

Mental Health

Mental health is as important as physical health. That's why we have the same coverage for both.

Required care is covered. This includes:

  • Behavioral therapy.
  • Substance abuse treatment.

Mosquito repellent

Mosquito repellent is available as a statewide benefit. Learn more.

English | Español

No Copays

You pay nothing for well-child or well-baby visits, covered drugs or immunizations.

While your family's 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.
  • Prescription drugs and over-the-counter medicines.

Nurse Hotline

Medical questions and situations come at inconvenient times. When you have questions about 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 caring for your child.
  • Advise you about getting care at a doctor visit or an urgent care center.
  • Suggest you go right to the emergency department.

Prenatal Visits

Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.

All recommended prenatal clinical visits and tests are covered by our plan.

At these visits, the clinic will:

  • Make sure both you and your baby are healthy.
  • Explain what to expect at each stage of your pregnancy.
  • Answer your questions.

Programs for Kids and Teens

Kids with positive role models make more healthy choices. That's why we provide free memberships to the Boys & Girls Clubs in your area.

Along with fun and games, these clubs offer help with:

  • Homework.
  • Mentoring.
  • Coaching.

Quitting Tobacco

You know the bad health effects of smoking. You know you need to quit. We will support you while you quit with coaches and supplies. The only thing you won't get from us is a lecture.

Transportation

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

Vision Care

Your child will get the care, eyeglasses and treatment to see life more clearly. Coverage includes $105 each year toward frames or contact lenses.

This benefit is offered by certain stores and retailers.

Weight Control

Get 10 vouchers toward local Weight Watchers programs for kids.

Weight Watchers helps children develop good eating habits and become more active. So your child will continue to grow and reach a healthy weight. The program also helps kids learn to make good choices about food and snacks.

Well Child Care

Preventive checkups, shots, eye and hearing exams.

Member Resources

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Learn More

Children's Health Insurance Program (CHIP)

Individual & Family ACA Marketplace Plans Disclaimer
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The benefits described may not be offered in all plans or in all states. Some plans may require copayments, deductibles and/or coinsurance for these benefits. This policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, review your plan documents, call or write your insurance agent or the company, whichever is applicable. Plan specifics and benefits vary by coverage area and by plan category. Please review plan details to learn more.

UnitedHealthcare Individual & Family plans medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.; Rocky Mountain Health Maintenance Organization Incorporated in CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc; UnitedHealthcare of Illinois, Inc.; UnitedHealthcare Insurance Company in AL, KS, LA, MO, NJ, and TN; Optimum Choice, Inc. in MD and VA; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of Mississippi, Inc.; UnitedHealthcare of New Mexico, Inc.; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Ohio, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of South Carolina, Inc.; UnitedHealthcare of Texas, Inc.; UnitedHealthcare of Oregon, Inc. in WA; and UnitedHealthcare of Wisconsin, Inc.  Administrative services provided by United HealthCare Services, Inc. or its affiliates.

This policy has exclusions, limitations, reduction of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company, whichever is applicable. By responding to this offer, you agree that a representative may contact you.

1 Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider. Virtual visits are not intended to address emergency or life-threatening medical conditions and should not be used in those circumstances. Services may not be available at all times, or in all locations, or for all members. Check your benefit plan to determine if these services are available. Data rates may apply. Certain prescriptions may not be available and other restrictions may apply.

2 Tier 2 prescriptions for $5 or less not available on all medications. 3-month fills apply to select maintenance medications only. Applicable formulary requirements such as prior authorization and quantity limits may apply to your pharmacy benefits. Walgreens discount valid until 12/31/24. Discount valid only for in-store purchases of eligible Walgreens brand health and wellness products by current members eligible for the UnitedHealthcare discount program. Discount cannot be used online. For a full list of Walgreens brand health and wellness products and exclusions, please visit www.walgreens.com/smartsavings.

Last Updated: 09.28.2023 at 06:55 PM CDT

Disclaimer Information
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Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Complete plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Premium Disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Nurse Hotline disclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. Nurse Hotline not for use in emergencies, for informational purposes only.

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid Plan)

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® (Medicare-Medicaid Plan)

UnitedHealthcare Connected® (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® for One Care (Medicare-Medicaid Plan)

UnitedHealthcare Connected® for One Care (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® general benefit disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® Member Handbook. 

UnitedHealthcare Senior Care Options (HMO SNP) Plan

UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare and does not have any other comprehensive health Insurance, except Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program.

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system. The 5 Star rating applies to plan year 2023.

Important provider information

The Choice is Yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non- contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

American Disabilities Act notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate information

To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call 1-888-638-6613 TTY 711, or use your preferred relay service.

Declaration of Disaster or Emergency

If you’re affected by a disaster or emergency declaration by the President or a Governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

  • Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non- contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
  • Where applicable, requirements for gatekeeper referrals are waived in full;
  • Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
  • The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.