FirstCare CHIP Plans

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CHIP 

The Children’s Health Insurance Program (CHIP) is a health plan for children 18 years and younger. CHIP is for families when their income is too high for Medicaid but they can't afford other insurance. CHIP covers health services like checkups, lab tests, x-rays, hospital stays, medicines, dental care, and more.

CHIP Perinatal 

CHIP Perinatal benefits are services to the unborn child of a pregnant woman who does not qualify for other Medicaid programs or traditional CHIP. The program will also continue services for some newborn children after delivery. To learn more about the program and other benefits for pregnant women, visit our Healthy Pregnancy page.

CHIP Perinatal Newborn 

Chip Perinatal Newborn coverage begins the day the child is born. Your baby will receive the CHIP Perinatal Newborn benefits. Coverage will end at the end of the 12 months of coverage from the month eligibility was determined.

Is there a cost to join CHIP?

There may be a cost to join FirstCare CHIP. The cost is based on the family income, assets and size. The cost may have an enrollment fee and co-payments.  Most co-payments for doctor visits and medicines drugs are from $3 to $20 for lower-income families and $20 to $35 for higher-income families.
 
Enrollment fees are $50 or less per family, per year. For more info, see the CHIP Yearly Enrollment Fees Chart.There is no cost to join the CHIP Perinatal program and no cost for care.

For more information on cost-sharing, see the CHIP Cost-Sharing Table.

How to Choose a Primary Care Provider

Your Primary Care Provider (PCP) must be a FirstCare CHIP provider: To find a participating provider, you can do one of the following:  When you fill out your Enrollment Form, list the PCP you have chosen. There is a space on the form for the name and provider number. Your PCP will be the doctor in charge of your health care. Visiting the same doctor for checkups and when you are sick can help your doctor keep an eye on your health. You can go to a family planning, OB/GYN, behavioral health, and/or other health care provider. You do not need a referral by a PCP. 

How does CHIP work?

CHIP Members - When you join CHIP, you will pick a doctor (PCP) for your child. Your child will be sent a CHIP ID card. The PCP you choose will be listed on your child's ID card. You will need to show your child's CHIP ID card at each doctor visit.

CHIP Perinatal Members - When you are a pregnant mother of an unborn child, you will pick a doctor (PCP) for care while you are pregnant. You will be sent a CHIP Perinatal ID card to use before your baby is born. You will need to show your CHIP Perinatal ID card at each doctor visit.

CHIP Perinatal Newborn Members - Once your baby is born, you will pick a doctor (PCP) for your baby. Your baby will be sent a CHIP Perinatal ID card. The PCP you choose will be listed on your baby’s ID card. You will need to show your baby’s CHIP Perinatal Newborn ID card at each doctor visit.

What are the benefits of FirstCare CHIP?

CHIP and CHIP Perinatal Newborn Benefits:
  • No limit on RX
  • Hospital care as long as medically needed
  • Doctor Visits

How do I access covered services?
What should I do if I have an emergency?

To access covered services, call FirstCare CHIP or CHIP Perinatal Customer Service at 1-877-639-2447. If you are having an emergency and need immediate medical care, go to the nearest Emergency Room (ER) or call 9-1-1. If you do not have life threatening injuries or symptoms or do not need immediate medical care, call your PCP first. Your doctor can help you and give you advice.  

How do I replace my ID card if it is lost or stolen?

If you need to replace your ID cards, call FirstCare Customer Service tollfree at 1-877-639-2447 and we can assist you.

Member Portal

FirstCare members have access to our online Member Portal. Here, you can look up your claims, view your benefits and find important plan documents.To log in/register, click here

You get free "extra" benefits in the Lubbock area

Keep your benefits!

CHIP enrollment will need to be renewed every 12 months. If you have questions, call FirstCare at 1-866-787-0663.

Need Help?
Contact Us!

Call FirstCare CHIP Customer Service at 1-877-639-2447. 

We're open Monday through Friday, from 8 a.m. to 5 p.m., excluding state approved holidays. If you call after hours, please leave us a message. We return all calls the next business day.
 
Our Customer Service Representatives speak both English and Spanish. If you speak another language, we can connect you with an interpreter. You can get information in larger print, audio (CD), braille, or in any other language format, if needed. For help, call FirstCare CHIP Customer Service at 1-877-639-2447.

Members with hearing loss can call FirstCare’s TTY line 1-800-562-5259 or the Relay Texas number 7-1-1. Relay Texas is a free telephone interpreting service to help people with hearing or speech disabilities.

Email: cservice@firstcare.com

Resources

CHIP Service Area CHIP Member News

Ask the Pharmacist

Have a question about a specific drug, or a drug benefit in your plan? Email our Pharmacist for the answers you need!

Talk to a Nurse—Nurse24™

Need care advice? Should you see a doctor? FirstCare members can talk to a nurse by calling 1-855-828-1013. Get answers 24 hours a day, 7 days a week! Information is available in English and Spanish. Interpreter services available upon request. TTY users can call 7-1-1 or 1-800-955-8771. Voice communication is available at 1-800-955-8770.

Utilization Management

Ever wonder how we decide to authorize services? Our decisions are based on medical evidence and consensus of health care professionals. For more details, click here.

Helpful Links and Phone Numbers

CHIPInformation and Referral:
2-1-1 or 1-877-541-7905
Helpline: 1-800-335-8957 
Enrollment Helpline: 1-800-964-2777
TTY: 1-800-735-2989 
MCNA Dental (CHIP)Medicaid & CHIP dental plan for Texas
1-855-691-6262
TTY: 1-800-955-8771
DentaQuest (CHIP)Medicaid & CHIP dental plan for Texas
1-800-508-6775
TTY: 1-800-855-2880
Navitus Health SolutionsFirstCare’s Pharmacy Benefit Manager 
1-877-908-6023
TTY: 7-1-1

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