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What does STAR Kids cover?

STAR Kids is Medicaid coverage for kids and young adults with disabilities in the Tarrant and Dallas service areas. As a member, you’ll enjoy benefits and services that can help you reach your health goals. To learn more, check our list of covered services:

Ready to enroll?

Get Started

Questions? Just call our helplines: 24-Hour Nurse Line: 1-800-556-1555 (TTY: 711). 

Member Services, behavioral health services and more: 1-844-787-5437 (TTY: 711)

The Aetna Better Health® difference

You deserve to be as healthy as you can be. That’s why we offer the support and tools you need to be your healthiest, bringing together what matters most to your health. It’s care you can trust. And experience you can count on — with extra benefits that go beyond your standard health coverage.

Pregnancy and newborn care

Are you expecting a child? We’ll help you stay healthy during and after your pregnancy. Our programs can help you and your baby get the care and services you need, such as breastfeeding support, info for new moms and more. You can even earn rewards for making healthy choices.

$30 for over-the-counter (OTC) products

You should have everything you need to help you feel your best. That’s why we’re working with CVS Health® to give you $30 of OTC health supplies and products. And we'll send it to you every month at no extra cost.

Rewards you can earn

Get rewards for taking care of your child’s health. Complete a preventive care step, such as a well-child checkup, and you can earn a $30 gift card. We’ll show you how it works.

24-Hour Nurse Line

Have questions about your health? You can talk to a nurse 24 hours a day, 7 days a week. They can help you find doctors, understand your medicines and much more.

Extra help with rides

Need help with getting rides to local resources, services or events? You can get daily bus passes for rides to:

 

  • WIC offices
  • Health plan community events or classes
  • Member Advisory Group meetings

We’ll also cover the cost of rides for the member’s:

 

  • Legally authorized representative (LAR; parent or guardian) 
  • The member’s siblings if the LAR can’t make other child care arrangements

Just contact us to learn more about extra help with rides. This extra help goes beyond the standard rides benefit. You can learn more about the standard benefit on the rides page

Even more benefits

Vision care: One eye exam every other year (ages 21 and older) and $175 toward glasses (frames and lenses) or contact lenses every year (ages 21 and under) or every other year (ages 21 and older)

 

To learn more, scroll down the page.

Benefits in your plan

Benefits in your plan

Learn about all your plan benefits, from vision and dental care to telehealth, maternity care and early childhood intervention (ECI).

 

Copays

 

Members don’t have any copays for the services we cover. You only have copays for medicines. If a provider bills you, don’t pay the bill. Just contact us.

 

Approval for services

 

Some services need approval, or prior authorization (PA), before you get them. We base all our decisions on whether the service is:

 

  • Needed for your health
  • Likely to help you
  • Covered 

You can learn more about PA. Just check your member handbook. Or visit our PA page.

 

We take care of the whole you. That means you’re covered if you need to see a specialist, have an emergency or plan to start a family. You have unlimited visits, so you can see your primary care physician (PCP) as many times as you need to — at no cost. You can also get a wide range of preventive care and vaccines.

 

Find a provider

A healthy smile goes a long way. Dental care is part of your overall health. That’s why you should see your dentist every six months. 

 

Check your member ID card from your dental plan. Then, call your plan for answers to questions about care and coverage:

 

Routine eye exams are an easy way to keep your eyes healthy. We work with Superior Vision to provide you with vision care and eye health services. Have questions? Just call 1-800-879-6901.

 

More about vision care

We make it easy to get the medicines you need to feel better. You may have a copay for those on your state’s preferred drug list (PDL). This is a list of medicines we cover. Don’t see yours on the list? Ask your provider to find a similar medicine. And you can fill your prescription at any pharmacy in our network. 
 

More about pharmacy benefits

Mental and behavioral health includes services for mental health and substance use. If you need help, we’re here for you. We’ll also connect you with local resources for more support.
 

What to do if you’re having a mental health crisis
 

No matter what time of day, you’re not alone. We have resources in place to help you in a crisis or mental health emergency. This includes thoughts of harming yourself or others. Here are some options for help: 

 

More about mental and behavioral health care

Our team helps you and your baby be as healthy as possible. Some benefits include:

 

  • Info about healthy pregnancies and baby care
  • Rewards you can earn for completing certain goals
  • Help from a service coordinator
  • Breastfeeding support
  • Text4baby™, a text service that sends health tips and reminders
  • Local community programs and resources
  • Info about family planning
  • Coverage of long-acting birth control

More about pregnancy care

ECI services help children from birth to age 3 who have developmental delays or disabilities. These services support families as their children learn and grow. You can check with the Texas Health and Human Services Commission to see if your child qualifies.

 

More about ECI services

You can get birth control counseling and supplies. And see in-network or out-of-network providers.

 

Any family planning care that you get is private. You can contact us to choose a family planning provider. Or you can read more about family planning.

Service coordination

 

Do you need help getting care? Our team is here for you. Service coordinators are nurses and social workers who understand your health conditions and help connect you to the right care. A service coordinator can help you learn more about your health, find a ride to your appointments and do many other things to help.  

 

More about service coordination

 

Chronic disease management

 

Some health issues need more care. Our care managers can help you manage chronic conditions like asthma, diabetes, chronic obstructive pulmonary disease (COPD) and more. 

 

More about chronic disease management

 

Extra help for asthma care

 

If you have asthma, we can help you take care of yourself year-round. You can get these supplies or services (up to $100/year) when you join our chronic disease management program:

 

  • Hypoallergenic bedding
  • Pest control services
  • Vent cleaning services
  • Deep cleaning services for your carpet

 

You can contact us to learn more about asthma care.

If it’s late at night or you can’t reach your PCP, you’re not alone. You can speak with a nurse about your health care questions 24 hours a day, 7 days a week. Not sure if you should find urgent care or go to the emergency room? The Nurse Line can help. It doesn’t take the place of your PCP though, so be sure to follow up later.

 

To reach the Nurse Line, just call 1-800-556-1555 (TTY: 711).  

It’s important to stay in contact with your health care team. And to be able to receive health tips and reminders by text. Need a smartphone? You can get one through Assurance Wireless® Lifeline at no cost to you. Your smartphone will include services, like:
 

  • Unlimited texts
  • 1,000 talk minutes
  • 4.5 GB of data each month, all on the T-Mobile Network
     

To see if you’re eligible for Assurance Wireless, go to Apply for your smartphone.


Apply for your smartphone

Through secure video on your computer, you can meet with a doctor for treatment of behavioral health and other common health conditions. Cold or flu? Great reasons to use telehealth. You can also get help with allergies, sinus problems and more.

 

More about telehealth

If you have no way to get to the hospital during an emergency, call 911.

 

If you don’t have a ride to your health care visit, we’ll help you get one. Nonemergent medical transportation (NEMT) services provide rides to normal health care visits, like:

 

  • Medical care
  • Dental care
  • Behavioral health care

These rides are not for emergencies. You can contact Access2Care at 1-866-411-8920 (TTY: 711) 24 hours a day, 7 days a week. Be sure to set up rides as early as you can, and at least:

 

  • Two business days before you need it for regular trips
  • Five business days for long-distance trips (more than 90 miles)

More about rides 

Members who qualify for Texas Health Steps can get free preventive care from birth to age 20. This includes medical and dental checkups, as well as vaccines/immunizations.

 

Physical exams for school and sports

 

We also cover physical exams for members (ages 19 and younger) who need them to attend school or play sports. Exams must be medically necessary. Members will need to complete their Texas Health Steps wellness checkup beforehand.

 

Check our member Texas Health Steps page to learn more.

Long-term services and supports (LTSS)

Long-term services and supports (LTSS)

LTSS helps families care for children and young adults who are medically dependent. The goal is to help you get care at home, in your own community, instead of at long-term care or nursing facilities.

 

These services and supports help with daily health care and living needs as well as safety and independence in your home or community. Have questions about LTSS? Just call 1-844-787-5437 (TTY: 711) and ask to speak to a service coordinator.

 

Respite care

 

For members of the Medically Dependent Children Program (MDCP), we’ll also cover another 10 hours of in-home respite services each month.

 

More about MDCP and other waivers

 

Health programs

 

These programs can help you live life as healthy as you can be. We have special programs and services to help you get the care you need. And prevent health issues in the future.

 

More about health programs

Other language and format needs

 

Need language help? Just contact us. You can get:

 

  • Interpreter services at no cost during any service or complaint process, including American Sign Language and real-time oral interpretation
  •  Interpreter services for your medical visit (be sure to call 48 hours before your visit)
  • Info in another format, like audio, large print and braille
  • Materials in other languages if your primary language isn’t English

Legal notices
 

Aetna is part of the CVS Health® family of companies. 

All trademarks are the property of their respective owners.

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