A little about our health plan
Cook Children's Health Plan has been serving the Tarrant Service Area Medicaid and CHIP families since 2000, which includes Members across Wise, Denton, Parker, Tarrant, Hood and Johnson counties. We ensure Members receive the physical and behavioral health, pharmacy and social support services you need, when and where you need them.
We are affiliated with Cook Children's Health Care System, an integrated pediatric delivery system that has over a century of service to North Texas Residents.
Choose your health progam
The CHIP, CHIP Perinatal, STAR, and STAR Kids programs allow you to choose doctors, clinics, hospitals and specialty services. Find the plan that’s right for your family.
CHIP
The Children’s Health Insurance Program (CHIP) offers low-cost healthcare for children ages 18 and under who are not eligible for Medicaid and don’t have health coverage.
CHIP Perinatal
CHIP perinatal services offer health care benefits to unborn children of pregnant women.
STAR (Medicaid)
State of Texas Access Reform (STAR) is a no-cost Medicaid-managed care program for pregnant women, children, and anyone who gets Temporary Assistance for Needy Families (TANF).
STAR Kids
STAR Kids is the first Medicaid-managed care program for children and young adults ages 20 and younger who have disabilities or complex health needs.
Important Contact Information
If you have any questions or concerns, our Member Experience team is readily available to assist you at 1-800-964-2247 (TTY/TDD for hearing impaired: 7-1-1 or 1-800-735-2988) Monday through Friday, 8AM - 5PM. We have staff that speaks English and Spanish. If you call us after hours or on the weekends, please leave us a voicemail and we will follow up with you within 1 business day.
If you are having an emergency, please contact 9-1-1.
Service coordination is available for our STAR Kids members. To learn more about service coordination, please visit our Service Coordination Programs page.
For other important contacts, please look through our list below that covers contacts for dental, vision, pharmacy, and more.
24/7 Nurse Hotline
Cook Children's Health Plan's Nurse Advice line is available to answer your health questions 24 hours a day, 7 days a week at no cost to you.
Our Nurse Advice Line staff can help you decide what kind of care to seek. You might be able to treat the condition at home, you might need to see your doctor, or you might need to get urgent or immediate care. The nurse line is staffed with registered nurses that understand pediatric care. The Nurse Advice Line staff speaks English and Spanish. If you speak another language and need an interpreter, just let them know and they will connect you with someone that speaks your language.
The Nurse Advice Line can help:
- Answer medical questions
- Provide care advice and help you determine if you need help right away.
- With medical conditions such as diabetes or asthma.
- If you don't know how much medicine to give your child
If you have a life-threatening medical emergency, call 911.
- Toll Free: 1-833-926-2408
- TTY/TDD (hearing impaired): 1-844-514-3774
Pharmacy Benefits Manager - Navitus
Navitus Health Solutions works as our pharmacy benefits manager. You can find a pharmacy directory, formulary (list of medicines), and more through their page. Please visit our Members Pharmacy page for more information.
Non-emergency Medical Transportation - Access2Care
If you need non-emergency transportation to your health care appointments, Access2Care can help arrange those services for you. They have bilingual staff that speak English and Spanish and interpreter services for other languages free of charge. Access2Care is available 24 hours a day, seven days a week. Members need to call at least 2 business days before their appointment.
- Toll Free: 1-844-572-8195 Access2Care is available 24 hours a day, seven days a week.
- TTY: 7-1-1 or 1-800-735-2988
- Where's My Ride: 1-844-572-8195
- Website: Access2Care
Vision Services - National Vision Administrators (NVA)
Members can get a vision exam and one pair of lenses and a frame once every 12 months. You do not need a referral from your child's Primary Care Provider to see the eye doctor. Your child can get eye care from any NVA vision provider.
Members can call National Vision Administrators, LLC. (NVA) for vision services.
- Toll-Free: 1-877-236-0661
- TTY/TDD (hearing impaired): 1-888-820-2990
- Member website: National Vision Adminstrators
- To find a Provider click here
Dental Managed Care Plans
There are three dental plans that service children on CHIP or Medicaid. Your dental plan includes statewide coverage and great benefits for you or your child. Among the care that is covered is:
- Basic care like check-ups, cleanings and X-rays
- Preventive care like fluoride treatments and sealants
- Other teeth problems like fillings, crowns, root canals and tooth removal
DentaQuest
- Toll-Free: 1-800-508-6775
- TTY/TDD (hearing impaired): 7-1-1
- Website: DentaQuest
MCNA
- Toll-free: 1-800-691-6262
- TTY/TDD (hearing impaired): 1-800-955-8771
- Website: MCNA
United Health Care Dental
- Toll-free: 1-877-901-7321
- TTY/TDD (hearing impaired): 7-1-1
- Website: UHC
Dental Value Add for pregnant women
Cook Children's Health Plan offers Up to $250 for basic and major dental services for CHIP Perinate members enrolled in the Cook Children's Health Plan's Baby Steps Program.
Liberty Dental:
- Toll-Free: 1-888-902-0349
- TTY/TDD: 1-866-222-4306
- Website: Liberty Dental
If you are experiencing a life-threatening emergency, please contact 9-1-1.
If you are experiencing a behavioral health crisis, you can call our Behavioral Health Crisis Line at 1-833-391-3733, this hotline is available 24 hours a day 7 days a week 365 days a year. The Behavioral Health Service Hotline has staff that are bilingual in English and Spanish (prevalent languages) and also offers interpreter services for other languages free of charge.
Service coordination is available for our STAR Kids members. To learn more about service coordination, please visit our Service Coordination Programs page.
Members can self refer and do not need a referral to obtain substance abuse services. If you need assistance locating substance use services in your area, please contact our member services at 1-800-964-2247 Monday through Friday, 8AM - 5PM, and they can assist with locating a provider.
You do not need to have a referral from your doctor to join. If you qualify for any of these programs, you can call us at 1-800-964-2247 Monday through Friday from 8:00 am to 5:00 p.m. local time. Members that are eligible for any of these programs that require contact between them and Cook Children's Health Plan staff will receive the following information:
- How they became eligible for the program
- How to use program services
- How to opt in or out of the program
Service Coordination Program outreach and ongoing management for our members will be made by phone. All calls are live between Service Coordinators and the member. If you do not want to join any of these programs, you can opt out at any time by calling the same number. This means that we will take you out of the program but it will not affect your benefits.
To learn more, please visit our Service Coordination Programs page.
Providers can contact our Provider Support Services line at 1-888-243-3312, Monday through Friday from 8AM - 5PM, for assistance with verifying member eligibility, claim status, and more.
Providers can also visit our Providers page or log into our Provider Portal for more information.
To join Cook Children's Health Plan, call the enrollment broker at 1-800-964-2777 (TTY: 7-1-1) for STAR (Medicaid) and CHIP or 1-877-782-6440 (TTY: 7-1-1) for STAR Kids. To apply or to check application status you can visit yourtexasbenefits.com.
The enrollment broker is available 8 a.m.-6 p.m., Mon-Fri.
You also have the option to leave a voicemail on the weekends and after hours to receive a callback on the next business day.
Upon Member request, following the internal appeal, the EMR process will be conducted by a separate entity, Independent Review Organization (IRO). The IRO is contracted by HHSC to complete an independent review of the healthcare services that were denied by Cook Children's Health Plan. The IRO will decide whether the health plan original adverse benefit determination must be reversed or affirmed
To learn more about the Member's External Medical Review/State Fair Hearing process and/or request assistance, the Member or Member's Representative can contact Cook Children's Health Plan at:
- Toll Free: 1-800-964-2247
- Toll Free TTY/TDD: 1-800-735-2988
- Email: CCHPDenialAndAppeal@cookchildrens.org
Member advocates are available to help you file an appeal. Please email CCHPMemberAdvocate@cookchildrens.org or call 1-800-964-2247 to reach a Member Advocate.