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CHIP Member Handbook. Blue Cross and Blue Shield of Texas. bcbstx.com/chip. Travis Service Area. Member Services: TTY: - PDF
CHIP Member Handbook. Blue Cross and Blue Shield of Texas. bcbstx.com/chip. Travis Service Area. Member Services: TTY:
Download "CHIP Member Handbook. Blue Cross and Blue Shield of Texas. bcbstx.com/chip. Travis Service Area. Member Services: 1-888-292-4480 TTY: 1-888-292-4485"
Veronica Murillo Toro
1 Blue Cross and Blue Shield of Texas CHIP Member Handbook Travis Service Area Effective Member Services: TTY: bcbstx.com/chip A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association TR1QC-09132 Welcome! Welcome to Blue Cross and Blue Shield of Texas (BCBSTX). Thank you for being a part of our health plan family. As a valued BCBSTX member, you are getting this book with information you need to help you get the most from your health plan. In this handbook, you will find: How to use providers in the network When you need our OK for health care services (prior authorization) What your plan covers and does not cover How your health plan works Your member rights and responsibilities Important phone numbers When to use the emergency room This handbook also explains: How we keep your health information private 24 Hour Nurse Line, a 24-hour, seven days a week nurse help line Checkups to help keep your family healthy What to do if you are pregnant Please read How to use Your BCBSTX Health Plan. You must have an OK from us before some types of specialty care will be covered. Make sure you use providers in the BCBSTX network. If no one in the network can give you the care you need, your primary care provider (PCP) will get an OK from us to send you to a provider that is not in the network. For emergency or urgent care to be covered, you do not need to get an OK from us at all. You do not need an OK from us or need to be referred by your PCP to see a family planning care provider. However, contraceptives are not covered if only for the purpose to prevent pregnancy. You may go to any qualified family planning provider. If you do not have a health care emergency, you must use a provider in the network. If you get non emergency care from a provider that is not in the network before you get the required OK from us, you may have to pay for that service. Your member ID card has been sent to you as a separate item. It includes a Health Assessment Questionnaire. Please fill it out and mail it back in the envelope provided. Your ID card lists your PCP. If you want to change your PCP, or look for a PCP, visit our website or call the CCC to request a BCBSTX Provider Directory. You can call us if you need help finding a doctor near you, or if you would like a new one and you do not have access to the Internet. If you need help or have not received your ID card, please call us toll-free at our Customer Care Center (CCC) number Or, if you have hearing or speech loss, you may call the text telephone (TTY) line at We look forward to serving you. Blue Cross and Blue Shield of Texas3 Table of Contents PART 1 How to use this book...2 Important phone numbers and information...3 PART 2 Important things to do... 4 PART 3 How to use your Blue Cross and Blue Shield of Texas (BCBSTX) health plan... 6 ID card Primary Care Providers Changing health plans PART 4 What is covered by BCBSTX Benefits Mental health and substance abuse PART 5 Value added services covered by BCBSTX PART 6 What is not covered by BCBSTX PART 7 How to fill your prescriptions PART 8 Emergency and urgent care services PART 9 Programs to help keep you well PART 10 Help with special services PART 11 How to resolve a problem with BCBSTX PART 12 If we can no longer serve you PART 13 Other things you may need to know PART 14 Your health care rights and responsibilities PART 15 BCBSTX service area PART 16 Definitions PART 17 Benefit quick reference guide PART 18 CHIP covered services TABLE OF CONTENTS 14 Part 1 How to use this book This BCBSTX Children s Health Insurance Plan (CHIP) Member Handbook includes a list of the benefits available to you/your child. It also includes a list of benefits that are not offered. This member handbook tells you how Blue Cross and Blue Shield of Texas (BCBSTX) works. It also tells you which services are covered and which services are not covered. We made this book easy to use by breaking it into parts. You can read any part at any time. To save you time, we suggest: Please read these parts first: Important Things to Do How to Use Your BCBSTX Health Plan Emergency and Urgent Care Services Then, take some time and read: What Is Covered by BCBSTX What Is Not Covered by BCBSTX These sections are important to read as well: Programs to Help Keep You Well Other Things You May Need to Know Your Health Care Rights and Responsibilities Important Phone Numbers Value Added Services Call the Customer Care Center (CCC) toll-free at if you need help with this book. Members with hearing or speech loss may call our TTY line at This book is offered in audio CD, large print, Braille or in languages other than English. If you have any questions, please call our CCC line Monday through Friday, from 7 a.m. to 6 p.m. Central Time. If you call between 6 p.m. and 7 a.m., or on the weekends, with a nonurgent question, you may leave a message with our answering service. Calls will be returned the next business day. You may also call 24 Hour Nurse Line, a toll-free nurse help line, 24 hours a day, seven days a week for questions about your health at Use of you, my or I apply if you are a CHIP member. Use of my child applies if your child is a CHIP member or a CHIP Perinate new born member. If your child has an emergency, get help right away. Call 911 or go to the nearest emergency room for medical care. Your child will be covered for emergency services even if the provider is not part of the BCBSTX network. Important phone numbers and information Questions? Call our toll-free numbers } BCBSTX Customer Care Center (CCC) CCC TTY (line for hearing or speech loss) Community Resource Coordinators (CRC) Hour Nurse Line 2 How to use this book5 Part 1 Important phone numbers and information Texas Information and referral line for State of Texas services: food, housing, senior services, health care, SNAP, Medicaid and CHIP. 24 Hour Nurse Line TTY BCBSTX Customer Care Center (CCC) Hours: Monday Friday, 7a.m. to 6 p.m. (Central time). After-hours and weekends, leave a non-urgent message on the answering machine and your call will be returned the next business day. For TTY after-hours and weekends, call Texas Relay at the numbers below. Help in offered in English and Spanish. Interpreter services are available. In an emergency, call 911. CCC TTY BCBSTX Community Resource Coordinators (CRC) Fax CHIP Program Help Line Davis Vision TTY DentaQuest Emergency call 911 or go to ER if it is an emergency Future Moms Program MCNA Dental Magellan Health Services (Behavioral Health and Substance Abuse) This line is open 24 hours a day, seven days a week. In case of an emergency, call 911. TTY Maximus Enrollment Broker (1-877-KIDS-NOW) National Poison Control Center Calls are routed to the office closest to you. Non Emergency Transport Texas Department of State Health Services (DSHS) Family Health Services Help and Referral Line Texas Immunization Registry Help Desk Immunization Division Texas Relay Service or Women, Infants and Children (WIC) Program TTY lines are only for members with hearing or speech loss. Important Phone numbers 36 Part 32 Important things to do You are important to us. We want to help you get the health care you need. Thank you for choosing BCBSTX You are/your child is eligible for this program because: You meet/your child meets certain eligibility criteria based on family income and size You are/your child is not eligible for Medicaid You are/your child is a U.S. citizen or qualified immigrant 4 Important things to do7 Part 2 Important things to do Keep your child s BCBSTX identification (ID) card with you at all times. Show it every time your child needs health care services. Do not let anyone else use your card. Check that the doctor on your ID card is the one you want. Your child s ID card lists his or her primary care provider (PCP). A PCP is your main health care provider. If you want a different PCP, let us know right away. Set up an initial health exam with your PCP right away. You or your child should be seen by a doctor within 90 days after joining BCBSTX. Your doctor will advise you of when Well Child checkups are needed and BCBSTX will send you reminders. A newborn should be seen by a doctor within 14 days after birth. During the first exam, the PCP learns about the patient s health care needs to help him or her stay healthy. Call your child s PCP before you get medical care, unless your child has an emergency. Your child s doctor s office will help you make an appointment for care. If you need a ride to and from medical visits, call the non emergency transport number. Members with hearing loss may call the TTY line. If your child has an emergency, get help right away. Call 911 or go to the nearest emergency room for medical care. Your child will be covered for emergency services even if the provider is not part of the BCBSTX network. If you have a health problem or question that is not an emergency, you can call 24 Hour Nurse Line, the toll-free nurse line, for help. Have your BCBSTX ID card ready when you call. The nurse will ask for your ID card number. They will help you get the care you need. Important things to do 58 Part 3 How to use your BCBSTX health plan Your child s BCBSTX ID card has these important details: Your child s name Your child s BCBSTX member ID number BCBSTX s name and claims address for providers to submit claims The BCBSTX toll-free Customer Care Center phone and TTY numbers for you to call us The date your child became a BCBSTX member (effective date) Your child s PCP name and phone number Your child s copay information (if you have a copay) What to do in an emergency The BCBSTX toll-free Customer Care Center phone number for questions about drugs Instructions for help in Spanish The phone number for 24 Hour Nurse Line, the 24-hour, toll-free nurse help line The phone numbers for vision, behavioral (mental) health and substance abuse services The initials TDI (Texas Department of Insurance) 6 How to use your BCBSTX health plan9 Part 3 How to use your BCBSTX health plan BCBSTX ID cards Show your or your child s BCBSTX ID card to the doctor, hospital or other provider when you go or take your child for health care services. Below are samples of what your card will look like: BCBSTX CHIP ID card Perinatal CHIP ID card - over 185% FPL CHIP Perinatal ID card - UnDER 185% FPL CHIP Perinatal ID card- NEWBORN How to use your BCBSTX health plan 710 Part 3 How to use your/your CHILD S BCBSTX ID Card You/your child will get a new BCBSTX ID card if: You change your/your child s PCP. The address or phone number for you/your child s PCP changes. You lose your/your child s ID card. If you/your child needs a new BCBSTX ID card, call our Customer Care Center (CCC) line. If you did not get your/your child s BCBSTX ID card, call our CCC line at the number below. Members with hearing or speech loss may call our TTY line. Always carry your/your child s BCBSTX ID card with you in case of an emergency. Only the person whose name is on the card can get services under this BCBSTX ID card number. If you let someone else use your/your child s card, you/your child could lose CHIP plan coverage. How to replace your/your child s BCBSTX ID card if it is lost: If your/your child s BCBSTX ID card is lost, call the CCC toll-free at If you have hearing or speech loss, you may call the TTY line at Choosing a Primary Care Provider (PCP) What is a Primary Care Provider (PCP)? A PCP is your/your child s main health care provider. Your/your child s BCBSTX ID card will have the name and phone number of the PCP you chose or the PCP assigned to you/your child if you didn t choose one. You can change PCPs if you want. A PCP can be a: Pediatrician Family or general practitioner Internist Obstetrician/gynecologist (OB/GYN)* Can a clinic be my/my child s PCP? Clinics such as Federally Qualified Health Centers (FQHCs), and rural health clinics can also be PCPs. Our Provider Directory lists PCPs who work with BCBSTX. It lists their addresses, phone numbers and hours they are open. *CHIP Perinate members do not get a PCP, they get an OB/GYN. 8 How to use your BCBSTX health plan11 How to use your BCBSTX health plan Provider Directory Look in the Provider Directory to: Choose a PCP for your child under Family Practice, Pediatrics or General Practice or FQHCs. Choose a provider for a pregnant member under Family Practice, Obstetrics and Gynecology or General Practice, or FQHCs. It is important to find the right PCP for your child. When choosing a PCP, you may have questions such as: Is the PCP a man or a woman? What language does the PCP speak? Is the PCP s office open on weekends? Is the PCP taking new patients? Physician incentive plans A physician incentive plan rewards doctors for treatments that reduce or limit services for people covered by CHIP. Right now, BCBSTX does not have a physician incentive plan. Changing YOUR/your child s PCP How can I change my or my child s PCP? If you want to do so, call our CCC line at Members with hearing or speech loss may call our TTY line at We want you to be happy with your PCP. Most of the time, it is best to keep the same PCP, so he or she can get to know your child s health needs and history. This information is also in the Provider Directory and on Provider Finder on the website. As a member of BCBSTX, you will get a new directory upon request. If you need a Provider Directory or need help choosing a PCP who s right for your child, call our CCC number at or look on our website at Members with hearing or speech loss may call our TTY line at If you would like to learn more about a PCP or a specialist, such as the doctor s specialty, medical school, residency training or board certification, visit these websites: American Medical Association at AIM DocFinder at The Texas Medical Board at How to use your BCBSTX health plan 912 Part 3 How many times can I change my or my child s PCP? There is no limit on how many times you can change your or your child s PCP. You can change PCPs by calling us toll-free at If you have hearing or speech loss, you may call the TTY line at You can also request to change your or your child s PCP by writing to us at: Blue Cross and Blue Shield of Texas P.O. Box Austin, Texas You must choose a doctor who will see new patients. We can help you find one. If you choose a PCP who is not taking new patients, we will help you choose another one. It is important to know that when you change your/your child s PCP often, your/your child s health care may not be as good as it could be. If you choose to change, have your/your child s medical records sent to the new PCP. When will my/my child s PCP change become effective? Your/your child s PCP change will be effective on the date the change is made and you can schedule an appointment that same day. Can a PCP move me or my child to another PCP for noncompliance? BCBSTX, or your/your child s PCP, may ask you to change your/your child s PCP if: BCBSTX no longer works with your child s PCP. You keep making appointments and don t show up for them. You are often late for your appointments. You or your child is rude or abusive, or disrupts the PCP s office. Are there any reasons why my request to change a PCP may be denied? A request to change your /your child s PCP may be denied if the PCP you want is not taking new patients. What if I choose to go to another doctor who is not my or my child s PCP? If you choose to go to a doctor who is not your/your child s PCP, call us first. We will try to make the doctor your/your child s PCP. If you see a doctor who is not your/your child s PCP without an OK from BCBSTX first, you may have to pay for the services you/your child gets. You will get a new ID card with the name of your/your child s new PCP and contact information on it in about five to seven days. 10 How to use your BCBSTX health plan13 How to use your BCBSTX health plan You need to set up the first prenatal care visit as follows: Within 14 calendar days from the date you call if you/your daughter is in the first three months of pregnancy. Within seven calendar days from the date you/your daughter call if you/your daughter is in the second three months of pregnancy. Within five business days from the date you call if you/your daughter is in the last three months of pregnancy. Call you/your daughter s OB/GYN and ask to set up an appointment within five business days, or right away, if you have an emergency. Also, call you/your daughter s OB/GYN if you think you/she has a high-risk condition that has to do with the pregnancy. Pregnancy care What if I/my daughter is pregnant? If you/your daughter is pregnant, you/your daughter does not need to see your PCP to approve care for pregnancy. But, you/your daughter will need to call us to make sure the OB/ GYN, and the birthing center or hospital where you/your daughter will have the baby, are both with BCBSTX. Whom do I need to call? Call our CCC line at as soon as you know you/your daughter is pregnant. We can tell you about Value Added Services we have for pregnant women. Because you/your daughter is pregnant, you/ your daughter may qualify for Medicaid. You/ your daughter must apply for Medicaid. If eligible you/your daughter will no longer be eligible and will be disenrolled from CHIP once you are enrolled in Medicaid. If you or your daughter are not eligible for Medicaid, you may be eligible for CHIP Perinate. Medicaid coverage will be coordinated to avoid gaps in health care coverage. If we are not aware of the member s pregnancy until delivery, CHIP will cover the delivery. The baby will be automatically enrolled in the mother s CHIP plan at birth and follows the same time frame as the mother to re-enroll and remain eligible. The member is covered until the date the coverage ends or through the end of the second full month after the month of the infant s birth, if that date is later. CHIP Perinate coverage ends at the end of the month of the infant s birth. How to use your BCBSTX health plan 1114 Part 3 Enrolling a newborn baby AND MOM FOR SERVICES Call our CCC line at as soon as you know your daughter is pregnant. Members with hearing or speech loss may call the TTY line at We will enroll her in a prenatal program. This will help her learn how to take care of herself while she is pregnant. Also, call your Health and Human Services Commission (HHSC) caseworker and tell him or her that you or your daughter is pregnant. Most newborns will be Medicaid-eligible. Eligibility must be determined before enrolling. If eligible, the baby will be covered from the beginning of the birth month until the next enrollment period. How do I pick a PCP for my baby? Who do I call? You can choose a PCP for your baby before the baby is born. You can also pick a PCP for your baby after the baby is born. Call us at our toll-free CCC number to choose your baby s PCP. Members with hearing or speech loss may call the CCC TTY line. If you do not choose a PCP, we will choose one for you. What information do they need? They will need your baby s name, date of birth and your member ID number. You can find your ID number on your BCBSTX ID card. If you have not already called us to choose a PCP for your daughter s baby, you can call after the baby is born. Call our CCC line at to choose the baby s PCP. Members with hearing or speech loss may call the TTY line at If you do not choose a PCP, we will choose one for you. The mother of the newborn may ask that the newborn s health plan coverage be changed to another health plan during the first 90 days after the baby is born. Call the CHIP enrollment broker, at or How to use your BCBSTX health plan15 How to use your BCBSTX health plan Making an appointment with your child s doctor Call your child s PCP for an appointment. Tell him or her that your child is a BCBSTX member. Have your child s BCBSTX ID card with you when you call. You may be asked for the ID number on the card. If you need a ride to the appointment, call the CRC to schedule. What do I need to bring with me to my or my child s doctor s appointment? Make sure to take your child s BCBSTX ID card with you to the doctor s appointment. Be on time for appointments. Call the doctor s office as soon as possible if: You will be late. You cannot keep your child s appointment. This will shorten everyone s time in the waiting room. The PCP may not be able to see your child if you are late. How do I get medical care after my/my child s PCP s office is closed? Call your child s PCP before he or she gets any medical care, unless it is an emergency. You can call the PCP s office 24 hours a day at the number on your child s BCBSTX ID card. After regular business hours, leave your name and phone number with the answering service. Either your child s PCP or an on-call doctor will call you back within 30 minutes. If you have an emergency, call 911 or go to the nearest emergency room. You can also call 24 Hour Nurse Line, the toll-free nurse help line at Initial Health Exam The first meeting with your child s new PCP is important. It is a time for you to get to know each other and talk about your child s health. The doctor will: Get to know your child and talk about your child s health. Help you understand your child s medical needs. Teach you ways to make your child s health better or help keep him or her healthy. We ask all new members to see their PCP as soon as possible but no later than 90 days after joining BCBSTX. Call your child s PCP to make an appointment today. Newborns should have at least six visits within the first 15 months of life. Routine medical care What is routine medical care? How soon can I/my child expect to be seen? Routine care is the regular care your child gets from his or her PCP to help keep your child healthy. This care includes checkups. You can call your child s PCP to make an appointment for routine care. Your child should be able to see his or her PCP within 14 days from the date you call to make the appointment. Urgent medical care What is urgent medical care? How soon can I/my child expect to be seen? An urgent medical condition is not an emergency, but needs medical care within 24 hours. When you call for urgent care, you can expect to be seen within 24 hours. How to use your BCBSTX health plan 1316 Part 3 Call your child s PCP if your child has an urgent medical condition. If you cannot reach your child s PCP: Call us at , 7 a.m. to 6 p.m. Members with hearing loss may call our TTY line at Call 24 Hour Nurse Line, the nurse help line, at Specialty care What if I/my child needs to see a special doctor (specialist)? If your child needs to see a specialist, your child s PCP may send your child to one for care or treatment. The PCP s office can help you make the appointment. Tell the PCP and the specialist as much as you can about your child s health, so you both can decide what is best for your child. Your child s PCP will help you choose a specialist who will give your child the care he or she needs. Your child s PCP must send an OK to a specialist before services are given. A specialist may treat your child for as long as he or she thinks your child needs treatment. How soon can I/my child expect to be seen by a specialist? You will get your child s referral within 30 days of the request. Whom do I call if I/my child has special health care needs and need someone to help me? Call us at our CCC line at and we will help you get access to the care your child needs. Members with hearing or speech loss may call the CCC TTY line Our nurses work with your PCP to make sure members with special health care needs have access to the right specialists for your condition and identified needs. This includes a standing referral to a specialty doctor, or a specialist as a PCP, if needed. 14 How to use your BCBSTX health plan17 How to use your BCBSTX health plan Prior Authorization (Our OK is needed ahead of time) Your child s PCP will get an OK from BCBSTX for some services to make sure they are covered. This means that both BCBSTX and your child s PCP (or specialist) agree that the services are medically needed. Medically needed means reasonable services to: Protect life. Keep your child from getting seriously ill or disabled. Reduce severe pain through the diagnosis or treatment of disease, illness or injury. See Part 4: What is covered by BCBSTX to check service limits. Your child s PCP can tell you more about this. We may ask your child s PCP why he or she needs special care. We may not OK the service you or your child s PCP asks for. We will send you and your child s PCP a letter to explain why we would not cover the service. It will tell you how to appeal our decision. You, or your child s PCP, may call us at our CCC line at You may also may write to us at: Blue Cross and Blue Shield of Texas P.O. Box Austin, Texas What is a referral? A referral is when your PCP sends you to another provider to get health care services. What services do not need a referral? Several types of care do not need an OK from your child s PCP: OB/GYN services (You must choose doctors in the BCBSTX network.) Family planning services (birth control pills, unless needed for a medical condition, are not covered.) Emergency care Outpatient behavioral health care such as mental health, drug and/or alcohol dependency services You must choose doctors in the Magellan Health Services network. Vision services Your child does not need an OK from BCBSTX to see a Davis Vision provider. To find an eye care provider in your area, call Davis Vision at Members with hearing or speech loss may call the Davis Vision TTY line at Getting a Second Medical Opinion You might have questions about care your child s doctor says your child needs. You may want a second opinion to: Diagnose an illness. Make sure the treatment plan is right for your child. You should speak to your child s doctor if you want a second opinion. Your child s doctor will send you to a doctor who: Also works with BCBSTX. Is the same kind of doctor your child saw first. Your child will be sent to a doctor who is not contracted with BCBSTX if there are no other doctors who are part of BCBSTX. You may call our CCC line at for help getting a second opinion. You may also call the 24 Hour Nurse Line, the 24-hour nurse help line, at , to learn more about second opinions. How to use your BCBSTX health plan 1518 Part 3 If you are denied a second opinion, you may appeal. See Part 11, How to resolve a problem with BCBSTX to file a complaint. How to Renew It s important to renew your CHIP/Children s Medicaid coverage on time or your child s coverage could end. You will get a renewal packet in the mail at least two months before your child s coverage is due to end. The packet will have an application form with some of the information already filled in. There are three ways to renew CHIP: 1. Online at 2. By mail - Send filled out application, a copy of at least one paycheck stub or other proof showing each family member s income and expenses. 3. By fax - Fax your filled out application to Regardless of the method you choose to renew, you must also pay your enrollment fee. You can mail a check or money order for the enrollment fee to: CHIP P.O. Box Dallas, Texas Or you can pay your enrollment fee with a credit card by calling What do I have to do if I move? As soon as you have your new address, give it to the local HHSC benefits office and the BCBSTX CCC at Members with hearing or speech loss may call the TTY line at Before you get CHIP services in your new area, you must call BCBSTX, unless you need emergency services. You will continue to get care through BCBSTX until HHSC changes your address. You must call us before you or your child can get any coverage for services in your new area unless you have an emergency. You will still get benefits through BCBSTX until your address is changed, unless you have moved out of the BCBSTX service area. We will assist you in finding doctors near your new home until you select a local plan. If you have any questions, please call our CCC line at , Monday through Friday, from 7 a.m. to 6 p.m. Members with hearing or speech loss may call the TTY line at You may also call 24 Hour Nurse Line, the toll-free nurse help line at Hour Nurse Line is available seven days a week. If you have a non-urgent question after normal business hours or on the weekend, you may leave a message with our answering service. Members with hearing or speech loss may call the TTY line at We will return your call the next business day. 16 How to use your BCBSTX health plan19 How to use your BCBSTX health plan What if I want to change health plans? Whom do I call? You are allowed to make health plan changes: For any reason within 90 days of enrollment in CHIP and once thereafter; For cause at any time; If you move to a different service delivery area; and During the annual CHIP re-enrollment period For more information, call CHIP toll-free at For CHIP Perinatal Program Members Attention: If you meet certain income requirements, your baby will be moved to Medicaid and get 12 months of continuous Medicaid coverage from date of birth. Your baby will continue to receive services through the CHIP program if you meet the CHIP Perinatal requirements. Your baby will get 12 months of continuous CHIP Perinatal coverage through his or her health plan beginning with the month of enrollment as an unborn child. Once you pick a health plan for your unborn child, the child must stay in this health plan until the child s CHIP Perinatal coverage ends. The 12 month CHIP Perinatal coverage begins when your unborn child is enrolled in CHIP Perinatal and continues after your child is born. If you live in an area with more than one CHIP health plan, and you do not pick a plan within 15 days of getting the enrollment packet, HHSC will pick a health plan for your unborn child and send you information about that health plan. If HHSC picks a health plan for your unborn child, you will have 90 days to pick another health plan if you are not happy with the plan HHSC chooses. If you have children covered by CHIP, their health plans might change once you are approved for CHIP Perinatal coverage. When a member of the family is approved for CHIP Perinatal coverage and picks a perinatal health plan, all children in the family that are enrolled in CHIP must join the health plan providing the CHIP Perinatal services. How many times can I change health plans? The children must remain with the same health plan until the end of the CHIP Perinatal member s enrollment period, or the end of the other children s enrollment period, whichever happens last. At that point, you can pick a different health plan for the children. You can ask to change health plans: For any reason within 90 days of enrollment in CHIP Perinatal; If the member moves into a different service delivery area; and For cause at any time. Whom do I call to change health plans? For more information, call the CHIP enrollment broker toll-free at How to use your BCBSTX health plan 1720 Part 4 What is covered by BCBSTX What are my CHIP benefits? Read this section for a list of the kinds of care your health plan covers. 18 WHAT IS COVERED BY BCBSTX Mostrar más
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