Mental Health and Substance Use Services for Adult Members
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.
Driscoll Health Plan Member Advocates are here to help you with writing complaints and will help you through the complaint process. If you need help with an appeal, a Member Advocate can help you file an appeal and walk you through the process. If you have a question about the covered services or preventative services of Driscoll Health Plan, call Member Services toll-free at 1-877-324-7543.
Driscoll Health Plan will provide you with information on how to schedule a ride through SafeRide Health. Call SafeRide Health to schedule and pick up at: 1-833-694-5881. To learn more about transportation, click here https://driscollhealthplan.com/services/transportation/
Our staff speaks English or Spanish and can help you with questions. We also have special services for people who have trouble reading, hearing, seeing, or speaking a language other than English or Spanish. You can ask for member materials in audio, larger print, Braille, and other languages. To get help, call our Member Services toll-free number on your ID card.
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 CHIP member: As soon as you have your new address, give it to HHSC by calling 2-1-1 or updating your account on yourtexasbenefits.com and call the Driscoll Health Plan Member Services Department at 1-877-451-5598. Before you get CHIP services in your new area, you must call Driscoll Health Plan, unless you need emergency services. You will continue to get care through Driscoll Health Plan until HHSC changes your address.
If you are a CHIP Perinate member: As soon as you have your new address, give it to the HHSC by calling 2-1-1, or updating your account on yourtexasbenefits.com and calling Driscoll Health Plan Member Services at 1-877-451-5598. Before you get CHIP services in your new area, you must call Driscoll Health Plan Member Services, unless you need emergency services. You will continue to get care through Driscoll Health Plan until HHSC changes your address.
If you get a bill from your Primary Care Provider or other Doctor, call Member Services at 1-877-451-5598 and someone will call the Doctor’s office. We will help to explain your benefits and copayments.
If you get a bill, call Member Services at the numbers shown to the right, and someone will help you. When you call, please have your ID card and doctor’s bill. Member Services will need this information to help you.
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 30 days for non-urgent care or within 24 hours for urgent care.
If you are a CHIP member and need a ride to the doctor’s office, SafeRide Health offers transportation services to medical appointments.
Phone Reservations: 1-833-694-5881
We can help you with a ride to the doctor.
If you lose your DHPID card, call us right away at 1-877-451-5598 to get a new one. We can mail you one right away. If you move or change phone numbers, call us so we can send you another ID card. We always need to have your correct address and phone number.
If you and/or your child gets sick at night or on the 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.
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:
Emergency care is available 24 hours a day, 7 days a week.
You and/or your child have an EMERGENCY medical need if:
There is no limit on how many times you can change your or your child’s primary care provider. You can change primary care providers by calling us toll-free at 1-877-451-5598.
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 1-877-451-5598.
You can change your PCP at any time. If you have seen your PCP within the current month, the change will become effective on the first day of the following month. If you have NOT seen your PCP within the current month, the change will become effective on the first day of the month in which the change is made. The PCP change may be expedited if DHP decides it is in the best interest of both the Member and the current PCP. You need to continue to see your current PCP until the change is effective.
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 1-877-451-5598.
You must take your DHP ID Card. 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.
