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Plans & Benefits: Texas STAR

Amerigroup is a health plan in the Texas STAR Program and helps you manage your health-care benefits if you’re a pregnant woman, a mother with child(ren), or a child through age 18. You’ll get STAR benefits like a doctor’s care and hospital care.

With Amerigroup, you’ll also get services like:

  • 24-hour Nurse HelpLine to answer your health questions
  • Member Services to help you with your benefits
  • Taking Care of Baby and Me®, a special care program for pregnant women
  • Beginning September 1, 2017, children and young adults in the Adoption Assistance and Permanency Care Assistance programs (AAPCA)

Keep your child healthy with Texas Health Steps

Texas Health Steps is health care for people age 20 and younger who have Medicaid. Starting at birth, your child can get medical checkups at no cost. Dental checkups are also no cost starting at 6 months of age.

Call Texas Health Steps toll-free at 1-877-847-8377 (1-877-THSTEPS) or go to
Texas Health Steps to learn more.

Are you a Farm Worker?

For more information, click here.

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?

Medicaid benefits through Amerigroup are provided at no cost to those who qualify.

Do I need a referral to see a specialist?

You will go to your primary care provider for most of your health care, or your primary care provider will send you 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.


STAR members do not have pharmacy copays.

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.

Q: I get Medicaid benefits through the AAPCA program, when will I move into STAR?

A: Starting September 1, 2017, people in AAPCA will move into STAR if they don’t:

  • Get Supplemental Security Income (SSI)
  • Get Medicare 1915(c) waiver services
  • Have a disability as determined by the U.S. Social Security Administration or the State of Texas
  • Don’t live in a nursing facility
  • Don’t live in an intermediate care facility for individuals with intellectual or developmental disabilities or related conditions (ICF/IID)

Q: Can I keep seeing my current doctors after I join a health plan as an AAPCA member?

A: You can keep seeing your current doctors if they’re in our health plan. We can approve for you to keep seeing your current doctors for 90 days if they’re not in our health plan. After 90 days, you’ll need to see a doctor in our plan, and we’ll help you find one.