STAR Complaints and Appeals Process

Filing a Complaint

If you have a complaint, please call us toll-free at 1-800-431-7798 to tell us about your problem. A FirstCare Member Services Advocate can help you file a complaint. Most of the time, we can help you right away or, at the most, within a few days.

This document contains information on how to make a complaint or file an appeal if you are a STAR Medicaid plan member.

If you don’t get the help you need from FirstCare, you should do one of the following:
  • Call the Medicaid Managed Care Helpline at 1-866-566-8989 (toll-free).
  • Email your complaint to HPM_Complaints@hhsc.state.tx.us.  
  • Write to: Texas Health and Human Services Commission
                  Office of the Ombudsman, MC H-700
                  P.O. Box 13247
                  Austin, TX 78711-3247
  • Fax 1-888-780-8099 (toll-tree)

Fair Hearing

You may ask for a Fair Hearing at any time during or after the appeal process. If you do not agree with FirstCare's decision, you may ask for a Fair Hearing from the State. You have 90 days from the date on the letter to request a Fair Hearing.
 
You can request a Fair Hearing by contacting FirstCare STAR at 1-800-431-7798.
 
If you would like to make your request in writing, please write:
FirstCare STAR
ATTN: Fair Hearing
1901 West Loop 289
Suite 9
Lubbock, TX 79407
 
You do not have a right to a Fair Hearing if Medicaid does not cover the service you requested.

Call 1-800-431-7798 if you need any help.



 

Need Help?
Contact Us!

Call FirstCare STAR Customer Service at 1-800-431-7798. 

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 STAR Customer Service at 1-800-431-7798.

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

STAR Medicaid Service Area STAR 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

Texas MedicaidInformation 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 
Texas Health Steps (THSteps)Health care for children, birth through age 20, who have Medicaid
1-877-847-8377 (1-877-THSTEPS)
MCNA Dental (Medicaid)Medicaid & CHIP dental plan for Texas
1-855-691-6262
TTY: 1-800-955-8771
DentaQuest (Medicaid)Medicaid & CHIP dental plan for Texas
1-800-516-0165
TTY: 1-800-855-2880
Navitus Health SolutionsFirstCare’s Pharmacy Benefit Manager 
1-877-908-6023
TTY: 7-1-1
OCCC Financial Literacy Information

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