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STAR

Texas STAR Benefits

Amerigroup is proud to serve STAR members in Texas. You or your child(ren) may be eligible for STAR benefits through Amerigroup if you live in our service area, and:

  • You’re pregnant
  • You’re age 20 or younger
  • You get Temporary Assistance for Needy Families (TANF)
  • You’re in the Adoption Assistance or Permanency Care Assistance (AAPCA) programs

STAR service areas

Amerigroup offers STAR in these service areas:

  • Bexar
  • Dallas
  • Harris
  • Jefferson
  • Lubbock
  • Tarrant
  • Rural Service Area – Central
  • Rural Service Area – Northeast
  • Rural Service Area – West

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

What you get with Amerigroup


Doctor icon

Visits to the doctor
$0

Hospital icon

Hospital Stays
$0

Prescription icon

Prescriptions
$0


There are no copays for covered services. Benefits include:

  • Primary care provider visits
  • Prescription drugs
  • Immunizations and wellness visits
  • Specialist visits
  • Urgent care
  • Emergency care
  • Lab and X-ray services
  • Pregnancy services
  • Family planning
  • Hospital care
  • Chiropractic services
  • Speech and hearing services
  • Physical therapy
  • Behavioral health care (mental health and substance abuse services)
  • Home health care
  • Disease management services

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

Find a Doctor

Staying healthy means getting regular checkups. Children need more wellness checkups than adults. These medical checkups, for children birth through age 20 who have Medicaid, are called Texas Health Steps. Your child should get Texas Health Steps checkups at:

  • Birth
  • 3-5 days old
  • 2 weeks old
  • 2 months old
  • 4 months old
  • 6 months old
  • 9 months old
  • 12 months old
  • 15 months old
  • 18 months old
  • 2 years old
  • 2 ½ years old

After age 2 ½, your child should visit the doctor every year.
Be sure to make these appointments and take your child to his or her doctor when scheduled. These checkups can:

  • Find health problems before they get worse and harder to treat
  • Prevent health problems that make it hard for your child to learn and grow

There is no cost for these checkups.

Questions about Texas Health Steps? Call 1-877-847-8377 (1-877-THSTEPS) or go to txhealthsteps.com.

Are you a seasonal farmworker? We will help you find doctors and clinics and help you set up appointments for your children. Your child can receive his or her checkup or service sooner if you are leaving the area. Learn more

Members age 20 and younger can get dental benefits through a dental managed care organization. Call your dental plan to find a dentist and learn about covered services:

  • DentaQuest: 1-800-516-0165
  • MCNA Dental: 1-800-494-6262

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

  • Members age 20 and younger can get an eye exam once every 12 months and prescription glasses (if necessary) once every 24 months
  • Members age 21 and older can get an eye exam and prescription glasses (if necessary) once every 24 months

You can get no-cost rides to your health-care appointments through the Medical Transportation Program (MTP). MTP can help with rides to the doctor, dentist, hospital, drug store, and any other place you get Medicaid services. You should schedule your ride at least 2 days before your appointment.

Dallas/Fort Worth

Call LogistiCare at 1-855-687-3255 Monday through Friday from 8 a.m. to 5 p.m.

Houston/Beaumont

Call Medical Transportation Management (MTM) at 1-855-687-4786 Monday through Friday from 7 a.m. to 6 p.m.

All other areas of Texas

Call MTP at 1-877-633-8747 (1-877-MED-TRIP) Monday through Friday from 8 a.m. to 5 p.m.

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

  • Free cellphone with monthly minutes and texts for those that qualify
  • Free first aid kit when you complete a personal disaster plan online
  • Rides to doctor visits when the Medical Transportation Program (MTP) is not available
  • Dental hygiene kit for members age 21 and older
  • Personal coaching to help quit smoking
  • Taking Care of Baby and Me® program for pregnant members and new moms
  • Up to $50 each school year for a Boys & Girls Club membership where available for members ages 6 to 18
  • One sports or school physical every year for members ages 6 to 18
  • Allergy-free pillow cover for members age 20 and younger 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 Texas Health Steps visit 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 3-20)
  • $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 adults

  • $20 each year for getting a flu (influenza) vaccination (age 18 or older)
  • $20 each year for getting a cholesterol exam (age 21 or older with cardiovascular disease)

For pregnant women

  • $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

For members with diabetes

  • $20 each year for having a retinopathy eye exam (ages 18-75)
  • $20 every 6 months for getting a blood sugar test (HbA1c) (age 18 or older)
  • $20 every 6 months for getting a blood sugar test (HbA1c) with a result less than 8 (age 18 or older)

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

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

Your benefits include a wide range of prescription and over-the-counter (OTC) drugs. We work with Express Scripts (ESI) to provide these benefits.

You do not have pharmacy copays.

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

Go to Pharmacy page

Some treatment, care, or services may need our approval before your doctor can provide them. This is called preapproval. Your 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

You may need to see a specialist or another provider for care or services that your primary care provider (PCP) can’t give you. You don’t need a referral from your PCP 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.

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 into your account and send us secure message

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 STAR at 1-800-964-2777 to join Amerigroup, or visit our How to enroll page.

How to enroll