FirstCare Member Resources
As a FirstCare Health Plans member, learn more about how you can use your FirstCare health care coverage to access the services you need, when you need them.
FirstCare Member Handbook
As a FirstCare member, your Member Handbook provides you with details about your plan, how to utilize the FirstCare network of physicians, and more. Click on the links below to access the Member Handbook for your plan:
Quick Reference Guides
Our priority is to provide you—the FirstCare member—with an exceptional health care coverage experience. These quick reference guides are designed to provide information about your coverage and help you get the most out of your plan. Click on the links below to access the Quick Reference Guide for your plan:
Annual Member Notice
Your FirstCare Member ID Card
Remember to carry your FirstCare member ID card with you at all times. You will need to show it to your provider(s) when you receive covered services. Your card contains important information, including your plan name, member ID number, copay/coinsurance amounts, and customer service phone number(s) to call if you have questions.
Click here to view samples of FirstCare ID cards.
NOTE: Information shown on your ID card may vary based on your plan benefits.
To print a temporary copy of your ID card, please log on to your member portal. You can also contact our Customer Service team and request your new card be mailed to you.
24/7 Self-Service Portal
We're committed to providing FirstCare members with access to high-quality health care in their communities, as well as tools and resources to understand and manage their health plan benefits. With the 24/7 Self-Service Portal you can enjoy access to your health plan through intuitive and mobile-friendly navigation—all within a secure environment that includes the resources you can count on from FirstCare. Click here for more information.
Find a Provider/Pharmacy
Looking for a doctor in your area? FirstCare's online provider directory helps you locate a doctor or hospital in your area. You can also find links to view your plan's pharmacy directory. To get started click here.
Click on the following links to access details on your plan's prescription drug network:
Health and Wellness—FirstCare Plus
Helping you stay healthy. That’s what FirstCare Plus is all about.
By combining personal health support with online tools and resources, you’ll have the tools to enhance your wellness experience:
- Take a customized health assessment.
- Check out any symptoms that are worrying you.
- Discover programs to help you take charge of your health and wellness.
- Expecting a child? Access our new Expecting the Best™ Maternity Program for information and educational tools.
Click
here for a link to
guidelines for health screenings and immunizations, provided by the Centers for Disease Control and Prevention (CDC).
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What Does It Mean?—A Health Insurance Glossary
Health insurance terms and phrases can be confusing, so we've compiled a list to help you.
Click here for a list of commonly used terms that can help you understand your plan and ask the right questions about your coverage
.
Questions? Contact Us!
If you have any questions about your plan, your benefits, or FirstCare—our Customer Service team is standing by, ready to assist you.
- Please call us, Monday through Friday, 7 a.m. - 7 p.m. CT
Hepatitis C Treatment
Hepatitis C Treatment Coverage and PDL Update Delayed to Jan. 1,2023
On Jan. 1, 2023, HHSC will designate one medication as the primary preferred direct-acting antiviral (DAA) drug option for treating Hepatitis C infection. HHSC will designate all other DAA drugs on the Medicaid formulary as non-preferred. HHSC originally announced these changes would occur on Sept. 1, 2022.
All Medicaid clients are eligible for DAA treatment with the primary preferred agent regardless of the client's METAVIR fibrosis score, and prior authorization is not required. Additionally, any enrolled Medicaid provider can prescribe the preferred drug and a drug screening is not required.
HHSC will publish an update to the Texas Medicaid Preferred Drug List (PDL) on Jan. 1 designate preferred and non-preferred options for DAA treatment. Drugs identified on the PDL as preferred are available without prior authorization.
For any non-preferred DAA drugs, HHSC will continue to apply PDL prior authorization criteria for all Medicaid clients, both fee-for-service and managed care. Additionally, HHSC will retire the following clinical prior authorization request forms for Hepatitis C treatment agents:
- Antiviral Agents for Hepatitis C Virus - Initial Request (HHS Form 1335)
- Antiviral Agents for Hepatitis C Virus - Initial Request - Addendum (HHS Form 1342)
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