STAR Kids Member Portal

STAR Kids is the first Medicaid managed care program for children and young adults, age 20 and younger, who have a disability and:

  • Have Supplemental Security Income (SSI) Medicaid or;
  • Are enrolled in one of the waiver programs listed below.

Members will get one-on-one help. Each member will have their own service coordinator that will help them get the healthcare services they need. Each member will have their health needs evaluated, which will be used to create the member’s individual service plan.

Driscoll Health Plan is committed to providing quality and caring healthcare to its members.

The SK-SAI is the assessment tool that is used to set up a detailed Care Plan for your child. The care plan is called an Individual Service Plan (ISP). The assessment will be completed by the Service Coordinator, the member and you. The SK-SAI will be completed in your home. We will schedule a convenient time to meet with you to complete the assessment. The SK-SAI will let both the family and the Service Coordinator have input into deciding what services and what amounts of each service are right for your child. The assessment will allow the Service Coordinator to set up the necessary authorizations to ensure that the medical care for your child is not disrupted. It may not mean that everything will be exactly the same. Our goal is to allow you and your child to have access to the providers you trust and to the services your child needs. Our promise to you is that the well-being of your child will always be a priority of our Service Coordinators.

A referral is a request from your Primary Care doctor for you to see another doctor.

Please note the following.

For the first twelve months after implementation of STAR Kids, you can:

    1. See a Medicaid physician specialist (in-network or out-of-network) with whom you have a relationship without a referral. This includes ones outside the service area. These physician specialists need to:
      1. follow DHP’s authorization and referral rules when asking for a referral to another provider with whom you have no relationship with, and
      2. provide updates or reports of your child’s care to your DHP PCP that is on your DHP ID card.
    2. You may see a Medicaid non-physician provider (in-network or out-of-network) with whom you have a relationship without a referral. This includes ones outside the service area.You can continue to see this provider as long as you have an existing State
      authorization for covered services until the earliest of the following three periods:

      1. six months from November 1, 2016,
      2. the authorization expires, or
      3. the STAR Kids assessment has been completed by the Service Coordinator, your child’s PCP and you, and
      4. you, the Service Coordinator and your child’s PCP have agreed on the new care plan.

The State will provide DHP with your child’s authorizations. If you need additional services, the provider must get in touch with your child’s PCP or your Service Coordinator.

  • If you need routine services from any new provider with whom you have no relationship with, you will need to obtain a referral from your PCP.
  • If you need one-time emergency or urgent service from a new physician specialist with whom you have no relationship with, you will not need to get a referral.

 

Nueces Service Area

  • Aransas
  • Bee
  • Brooks
  • Calhoun
  • Calhoun
  • Goliad
  • Jim Wells
  • Karnes
  • Kenedy
  • Kleberg
  • Live Oak
  • Nueces
  • Refugio
  • San Patricio
  • Victoria
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Hidalgo Service Area

  • Cameron
  • Duval
  • Hidalgo
  • Jim Hogg
  • Maverick
  • McMullen
  • Starr
  • Webb
  • Willacy
  • Zapatali
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