Frequently Asked Questions

What do I bring with me to my Doctor's appointments?

Bring a list of medicines you and/or your child are taking. If you take your child, also remember to take your child's shot records.
STAR Members: You must take both your Texas Benefit Medicaid Card and your DHP ID Card
CHIP Members: You must take your DHP ID Card

How do I change my Primary Care Provider (PCP)?

Having a medical home is very important. It makes sure that you and/or your child have a doctor that you know and trust for all your medical needs. If for any reason you need to change your PCP, call Member Services at 1-877-220-6376 (Nueces) or 1-855-425-3247 (Hidalgo).

When will my PCP change become effective?

You may change your PCP at anytime. If you call BEFORE the 5th of the month, the change will become effective immediately. If you call AFTER the 5th of the month, the change will be effective the first of the next month. You need to continue to see your current PCP until the change is effective.

Can a clinic be my PCP?

You and/or your child may choose a clinic as your PCP. This can be a Federally Qualified Health Center (FQHC) or a Rural Health Clinic (RHC). A hospital-based clinic such as the Spohn Family Health Clinics can also be your PCP. To choose a clinic as your PCP or if you have questions call Member Services at 1-877-220-6376 (Nueces) or 1-855-425-3247 (Hidalgo).

How many times may I change my PCP?

You may change your and/or your child's PCP up to four (4) times every year. Changing your PCP frequently can interfere with your and/or your child's medical care.

What is emergency medical condition?

Emergency Medical Condition means a medical condition manifesting itself by acute symptoms of recent onset and sufficient severity (including severe pain), such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical care could result in:

• Placing the patient's health in serious jeopardy;
• Serious impairment of bodily functions;
• Serious dysfunction of any bodily organ or part;
• Serious disfigurement; or
• In the case of a pregnant women, serious jeopardy to the health of a woman and her unborn child.

You and/or your child have an EMERGENCY medical need if:

• You think you and/or your child's condition is life threatening;
• You and/or your child has serious pain; or
• Serious harm could come to you and/or your child if you do not get immediate medical care.

How do I get medical care after my PCP's office is closed?

If you and/or your child gets sick at night or in a weekend and cannot wait to get medical care, call your PCP for advice. If you and/or your child have a fever or a sore throat and you are not sure what to do, call your PCP's office. Your PCP or another doctor are available by phone 24 hours a day, 7 days a week.

What do I do if my child and/or I become sick when out of town or traveling?

If you and/or your child get sick while you are out of town or out of state, call your PCP. Your PCP's phone number is listed on the front of your DHP ID card. You may also call Member Services at the number on the back of your ID card. If you and/or your child have an emergency while you are out of town or out of state, go to the nearest ER.

Driscoll Health Plan does not cover any care outside of the United States.

If I don't have a car, can I get a ride to the doctor's office?

If you are STAR member and need a ride to the doctor's office, you can get help from the Medical Transportation Program (MTP). Call MTP as soon as you know you will need a ride. The number is 1-877-633-8747.

If you are CHIP member and need a ride to the doctor's office, call Member Services at 1-877-220-6376 (Nueces) or 1-855-425-3247 (Hidalgo). We can help you with a ride to the doctor.

When do I need a referral?

Your PCP will tell you when you and/or your child need to see a specialist. Your PCP will make sure that you and/or your child get the special care needed. Most of the time you cannot go to another doctor or get a special service if your PCP does not agree to make a referral. A referral is when your PCP sends you to another doctor. You should expect the specialist to give you an appointment within 2 weeks for non-urgent care or within 24 hours for urgent care.

What do I do if I get a bill?

If you get a bill, call Member Services at the numbers shown above, and someone will help you. When you call, please have your ID card and the doctor's bill. Member Services will need this information to help you.

What do I do if I move?

You must report your new address before getting any services in your new area unless it is an emergency. If you have moved out of the DHP service area you will be reassigned to a new health plan. You will continue to get care through DHP until the address is changed.

If you are a STAR member: Report your new address as soon as possible to the local Medicaid Eligibility Office at 1-800-964-2777 and the DHP Member Services at 1-877-220-6376 (Nueces) or 1-855-425-3247 (Hidalgo).

If you are a CHIP member: Report your new address as soon as possible to CHIP Enrollment Office at 1-800-647-6558 and to DHP Member Services at 1-877-220-6376 (Nueces) or 1-855-425-3247 (Hidalgo).