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Plans & Benefits: Texas CHIP

Amerigroup is a health plan in the Texas CHIP program in the Bexar, Dallas, Fort Worth, Harris, and Jefferson service areas. CHIP provides a wide range of benefits, including doctor visits, hospital stays, X-ray and lab services, well-baby and well-child visits, etc.

Benefits Overview

Here is a summary of the benefits you get as an Amerigroup member.

Benefits Overview

Do you need a referral or prior authorization?

Sometimes your primary care provider will need you to see a specialist or another provider for care or services he or she can’t provide. This is called a referral. Your doctor may also need us to approve certain services before you get them. This is called prior authorization. You can get OB/GYN, family planning, and behavioral health services without a referral from your doctor. This is called self-referral. To get these services, make an appointment with a doctor in our network. You can find a list of doctors using the Find a Doctor search tool.

To learn more about referrals and prior authorizations, click on the links below.

Referrals and Prior Authorizations

What does it cost?

CHIP enrollment fees and copays are based on family income. Enrollment fees are $50 or less per family for each 12-month term of eligibility. Copays for doctor visits and prescription drugs range from $3 to $35, depending on your income. Find out more by visiting the CHIP website.

Does my child need a referral to see a specialist?

Your child will go to his or her primary care provider for most health care, or the primary care provider will send him or her to a specialist in the Amerigroup network. For more information, please check your member handbook or call Member Services at 1-800-600-4441 (TTY 711).

Eligibility & Enrollment

Get the benefits you need — doctor care, hospital care, health screenings, prescription coverage, and more. Find out if you’re eligible and how to choose Amerigroup.

Eligibility & Enrollment

Pharmacy & Prescription Drugs

Amerigroup works with Express Scripts to provide your pharmacy benefit. We cover a wide range of prescriptions and many over-the-counter medicines.If you have CHIP, you may or may not have a copay for your medicine. To see what your copay is, refer to the CHIP member handbook and your member ID card.

Search for name brand and generic drugs
that are on your formulary:

Searchable Formulary

Pharmacy & Prescription Drugs

Prior Authorization

You can email and ask us for an exception at wrkgp-submitmyexceptionreq@anthem.com.

Drug Interactions and Side Effects

Learn more about drug interactions or side effects on the ESI Drug Information website.

Express Scripts Prescription Drug Reimbursement Form

ESI Online Registration Instructions

FAQs

Find answers to your questions below.