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CHIP

Texas CHIP Benefits

Your kids are your priority, and we want to help them get the care they need to stay healthy. CHIP is the Children’s Health Insurance Program that offers low- or no-cost health-care benefits for kids. To be eligible for CHIP benefits through Amerigroup, your child(ren) must live in our service area and be:

  • Age 18 or younger and a U.S. citizen or legal permanent resident
  • Ineligible for Medicaid because your family income is too high
  • Without other private health insurance

CHIP service areas

Amerigroup offers CHIP in these service areas:

  • Bexar
  • Dallas
  • Harris
  • Jefferson
  • Tarrant

Not sure of your service area? Visit our Know Your Service Area page.

What you get with Amerigroup


Doctor icon

Visits to the doctor

Dental icon

Dental exams

Vision icon

Eye exams and glasses

Prescription icon

Prescriptions


Your child’s benefits include:

  • Regular checkups and office visits
  • Prescription drugs and vaccines
  • Specialist visits
  • Lab and X-ray services
  • Behavioral health care (mental health and substance abuse services)
  • Hospital care and services
  • Medical supplies

See your member handbook for a full list of benefits in your plan.

Find a Doctor

Dental benefits are offered through a dental managed care organization. Call your child’s dental plan to find a dentist and learn about covered services:

  • DentaQuest: 1-800-508-6775
  • MCNA Dental: 1-800-494-6262

Amerigroup offers vision care through Superior Vision of Texas. To find or change your child’s eye doctor, call Superior Vision of Texas at 1-800-428-8789.

We’re about more than just doctor visits. These extra benefits are designed to make a difference in your child’s life.

  • One sports or school physical every year for members ages 6 to 18
  • Up to $50 each school year for a Boys & Girls Club membership where available for members ages 6 to 18
  • Rides to doctor visits for members with chronic illnesses
  • Free cellphone with monthly minutes and texts for those that qualify
  • Free first aid kit when you complete a personal disaster plan online
  • Personal coaching to help quit smoking
  • Taking Care of Baby and Me® program for pregnant members and new moms
  • Allergy-free pillow cover for members with asthma

You can find specific benefit details, including exclusions and limitations, in your member handbook.

Sign up for our Real Solutions® Healthy Rewards program and earn debit card dollars for completing healthy activities, like getting certain checkups or screenings.

For children

  • $120 for completing 6 well-child checkups per the American Academy of Pediatrics recommended schedule (ages 0-15 months)
  • $20 per visit for well-child checkups (at ages 18, 24, or 30 months)
  • $20 each year for well-child checkups (ages 3-18)
  • $20 for getting a full series of rotavirus vaccinations (ages 42 days through 24 months)
  • $20 for getting a full series of flu (influenza) vaccinations (ages 6 months through 24 months)

For pregnant members

  • $25 for getting a prenatal checkup in the first trimester of pregnancy or within 42 days of joining
  • $50 for getting a postpartum checkup within 21 to 56 days after giving birth

Create your account at www.myamerigroup.com/HealthyRewards or call 1-877-868-2004 (TTY 711).

Visit Healthy Rewards

You can find specific benefit details, including exclusions and limitations, in your member handbook.

Your child’s benefits include a wide range of prescription drugs. We work with Express Scripts (ESI) to provide these benefits.

You can find your child’s pharmacy copay amount on their member ID card or in the member handbook.

Visit the Pharmacy page to find a pharmacy near you and check if your child’s medicine is covered.

Go to Pharmacy page

Some treatment, care, or services may need our approval before your child’s doctor can provide them. This is called preapproval. Your child’s doctor will work directly with us to get the approval.

You will need preapproval for:

  • Most surgeries, including some outpatient surgeries
  • All elective and nonurgent inpatient services and admissions
  • Chiropractic services
  • Most behavioral health and substance abuse services (except routine outpatient and emergency services)
  • Certain prescriptions
  • Certain durable medical equipment, including prosthetics and orthotics
  • Certain gastroenterology procedures
  • Digital hearing aids
  • Home health services
  • Hospice services
  • Rehabilitation therapy (physical, occupational, respiratory, and speech therapies)
  • Genetic testing
  • Sleep studies
  • Out-of-area or out-of-network care except in an emergency
  • Advanced imaging (things like MRAs, MRIs, CT scans, and CTA scans)
  • Certain pain management testing and procedures

This list is subject to change without notice and isn’t a complete list of covered plan benefits. Learn more about your benefits by:

  • Reading your member handbook
  • Calling Member Services with questions about specific services

Referrals

Your child may need to see a specialist or another provider for care or services that his or her primary care provider can’t provide. Your child doesn’t need a referral from his or her primary care provider to get care from other doctors in our plan. It’s a good idea to talk to your primary care provider first about other types of care you may need. He or she can tell you about other doctors in our plan and help you coordinate the care you receive.

Low-cost enrollment fees and copays

CHIP enrollment fees and copays are based on family income. Enrollment fees are $50  or less per family, per year. Some families pay no enrollment fee. Copays for doctor visits and prescriptions range from $0 to $5 for lower-income families and $10 to $35 for higher-income families.

Check your Member ID card or read your member handbook to find your costs.

Member Handbook – English
Member Handbook – Spanish

Member resources

We want you to understand your benefits and receive the best possible care. Here are some resources to help.

Member Handbook

Additional benefit information can be found in your member handbook.

Member Services

If you have any questions, call Member Services at 1-800-600-4441 (TTY 711). Our team is available Monday through Friday from 7 a.m. to 6 p.m. Central time.

Log in to your account to send us a secure message

CHIP logo

24-hour Nurse HelpLine


Whether it’s 3 a.m. or a Sunday afternoon, health issues come up. That’s why you can always call our
24-hour Nurse HelpLine and speak directly to a nurse.

Call 1-800-600-4441 (TTY 711) anytime, day or night, even on weekends and holidays.

Not yet a member?

Let us be your partner for a healthier life. Call the CHIP Helpline at 1-800-964-2777 to join Amerigroup, or visit our How to enroll page.

How to enroll