How your plan works
Every CHIP plan has the same benefits, but there
are differences in the co-payment amounts. Co-payments, the amount you are
required to pay, for medical services or prescriptions are paid to the
provider at the time of service. You will find information about your
child’s plan in the scope of benefits. It is also inserted in the
pocket of the member handbook.
Your child will have his or her own member ID
card. Always carry this card with you. It has important information needed
to receive care. Show it to any health care provider before your child
receives care or has a prescription filled. The ID card tells them that
your child is covered by Texas Children’s Health Plan. If you do not show
your child’s ID card, you may be billed for the care your child receives.
The ID card also lists the co-payments for covered health care.
Do not let other people use your child’s ID
card. If it is lost or stolen, call Texas Children’s Health Plan Member
Services.
CHIP cost-sharing
limits
The member guide you received from CHIP when you enrolled includes a
tear-out form that you should use to track your CHIP costs. To make sure
you do not go over your cost-sharing limit, please keep track of your
CHIP-related costs on this form. The enrollment packet welcome letter
tells you exactly how much you must spend before you are eligible to mail
the form back to CHIP. If you have lost your welcome letter, please call
CHIP toll free at 1-877-543-7669 and they will tell you your annual
cost-sharing limit.
When you reach your annual limit, please send the form to CHIP and they
will notify your health plan. Your health plan will issue a new member ID
card. This new card will show that no co-payments are due when your child
receives care.
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