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Cook Children's Health Plan

Contact Us

If you need to contact Cook Children’s Health Plan, or any of the companies that work with us then use the numbers below. The contact numbers are divided by STAR, CHIP and STAR Kids.


STAR

Mailing address

Cook Children's Health Plan
P.O. Box 2488
Fort Worth, TX 76113

Member Services

Our hours of operation are 8 a.m. to 5 p.m. Monday through Friday, except for state holidays. If you call after 5pm or the weekend or holiday, leave a message and your call will be returned the next business day.

You can call Member Services for:

  • Pharmacy questions
  • PCP changes
  • New member ID card
  • Benefit questions

All of our Member services representatives are bilingual in English and Spanish. If you need a face-to-face interpreter to go with you to your appointment, please call Member Services to schedule one.

Emergency care

Conditions that need immediate attention and without it you think will cause serious harm or jeopardy to your health are considered emergency care. If you have a life-threatening condition or behavioral health crisis, go to the nearest emergency room or call 911. You do not need a referral for emergency care. For a behavioral health crisis call Beacon Health Options at 1-855-481-7045.

Pharmacy

Healthy members are very important to us. We are here to answer your questions to make sure your prescription benefit program works for you. This is your benefit and we want you to have convenient access to information that helps you manage your health.

Use our Navi-Gate for Members web portal to access information about:

  • General pharmacy benefit information
  • Formulary
  • Pharmacy search
  • Drug search
  • Drug recall notifications
  • Easy access to direct member reimbursement (paper) claim forms

Members can call:

For Pharmacies and Prescribers only:

Toll Free: 1-877-908-6023.

The hours of operation are 8 a.m. to 5 p.m. Monday through Friday, except for state holidays. If you call after 5pm or the weekend or holiday, leave a message and your call will be returned the next business day.

All of the representatives are bilingual in English and Spanish.

Provider Relations

The hours of operation are 8 a.m. to 5 p.m. Monday through Friday, except for state holidays.

Providers can call Provider Relations for:

  • Credentialing
  • Provider contracts
  • Name change
  • Address change
  • NPI/TPI update
  • Phone and fax update
  • Billing company change
  • Letter of interest questionnaire

If you need to file a complaint with the state, send an email to Provider Complaints.

Nurse Advice Line 24/7

Cook Children's Health Plan's Nurse Advice line is available to answer your health questions 24 hours a day, 7 days a week at no cost to you. 

Our Nurse Advice Line staff can help you decide what kind of care to seek. You might be able to treat the condition at home, you might need to see your doctor, or you might need to get urgent or immediate care. The nurse line is staffed with registered nurses that understand pediatric care. The Nurse Advice Line staff speaks English and Spanish. If you speak another language and need an interpreter, just let them know and they will connect you with someone that speaks your language.

The Nurse Advice Line can help:

  • Answer medical questions
  • Provide care advice and help you determine if you need help right away.
  • With medical conditions such as diabetes or asthma.
  • If you don't know how much medicine to give your child

If you have a life-threatening medical emergency, call 911.

Non Emergency Medical Transportation (NEMT) - Access2Care

If you need non-emergency transportation to your health care appointments, Access2Care can help arrange those services for you. They have bilingual staff that speak English and Spanish and interpreter services for other languages free of charge. Access2Care is available 24 hours a day, seven days a week. Members need to call at least 2 business days before their appointment.

  • Toll Free: 1-844-572-8195
  • TTY: 7-1-1 or 1-800-735-2988
  • Where's My Ride: 1-844-572-8195
  • Website: Access2Care

Behavioral health- substance abuse services

Cook Children’s Health Plan has arranged for confidential mental health and drug or alcohol abuse services by Beacon Health Options. You do not need a referral to get these services. They are available 24/7. If you have a life-threatening condition or behavioral health crisis, go to the nearest emergency room or call 911.

They have bilingual staff in English and Spanish and also interpreter services for other languages free of charge. 

Vision services (National Vision Administrators, LLC)

Members can get a vision exam and one pair of lenses and a frame once every 12 months. You do not need a referral from your child's Primary Care Provider to see the eye doctor. Your child can get eye care from any NVA vision provider.

Members can call National Vision Administrators, LLC. (NVA) for vision services.

Dental managed care plans

There are two dental plans that service children on CHIP or Medicaid. Your dental plan includes statewide coverage and great benefits for you or your child. Among the care that is covered is:

  • Basic care like check-ups, cleanings and X-rays
  • Preventive care like fluoride treatments and sealants
  • Other teeth problems like fillings, crowns, root canals and tooth removal

DentaQuest

  • Toll-Free: 1-800-508-6775
  • TTY/TDD (hearing impaired): 7-1-1
  • Website: DentaQuest

MCNA

  • Toll-free: 1-800-691-6262
  • TTY/TDD (hearing impaired): 1-800-955-8771
  • Website: MCNA

United Health Care Dental

Dental Value Add for pregnant women

Cook Children's Health Plan offers Up to $250 for basic and major dental services for CHIP Perinate members enrolled in the Cook Children’s Health Plan’s Baby Steps Program.

Liberty Dental:

  • Toll-Free: 1-888-902-0349
  • TTY/TDD: 1-866-222-4306
  • Website: Liberty Dental

Medicaid Managed Care Program Helpline (Ombudsman)

The Office of the Ombudsman is designed to help people already on Medicaid but need help getting health care services. A priority is placed on people with urgent or complex health care needs get help that includes:

  • Information about the Member's coverage
  • Guidance on how to get services
  • Referrals to the right place to get help
  • Direct help from their staff to help resolve a problem
    • Toll-Free: 1-866-566-8989
    • TTY/TDD: 1-800-735-2989

The hours of operation are Monday to Friday from 8a.m. to 5p.m.

For mail:

Texas Health and Human Services Commission
Office of Ombudsman, MC H-700
P O Box 13247
Austin, TX 78711-3247
Website: Ombudsman

To Submit a complaint to the office of the Ombudsman click here

Fair hearing contact information

If you would like to file a request for a State Fair Hearing, call us and we will help you get the process started.

  • Toll Free: 1-800-964-2247
  • Toll Free TTY/TDD: 1-800-735-2988

If you have any questions, please call Member Services at 1-800-964-2247 or Provider Services at 1-888-243-3312 Monday through Friday from 8 a.m. to 5 p.m.


CHIP

Mailing address

Cook Children's Health Plan
P.O. Box 2488
Fort Worth, TX 76113

Member Services

Our hours of operation are 8 a.m. to 5 p.m. Monday through Friday, except for state holidays. If you call after 5pm or the weekend or holiday, leave a message and your call will be returned the next business day.

You can call Member Services for:

  • Pharmacy questions
  • PCP changes
  • New member ID card
  • Benefit questions

All of our Member services representatives are bilingual in English and Spanish. If you need a face-to-face interpreter to go with you to your appointment, please call Member Services to schedule one.

Emergency care

Conditions that need immediate attention and without it you think will cause serious harm or jeopardy to your health are considered emergency care. If you have a life-threatening condition or behavioral health crisis, go to the nearest emergency room or call 911. You do not need a referral for emergency care. For a behavioral health crisis call Beacon Health Options at 1-855-481-7045.

Pharmacy

Healthy members are very important to us. We are here to answer your questions to make sure your prescription benefit program works for you. This is your benefit and we want you to have convenient access to information that helps you manage your health.

Use our Navi-Gate for Members web portal to access information about:

  • General pharmacy benefit information
  • Formulary
  • Pharmacy search
  • Drug search
  • Drug recall notifications
  • Easy access to direct member reimbursement (paper) claim forms

Members can call:

For Pharmacies and Prescribers only:

  • Toll Free: 1-877-908-6023
  • The hours of operation are 8 a.m. to 5 p.m. Monday through Friday, except for state holidays. If you call after 5pm or the weekend or holiday, leave a message and your call will be returned the next business day.

    All of the representatives are bilingual in English and Spanish.

    Provider Relations

    The hours of operation are 8 a.m. to 5 p.m. Monday through Friday, except for state holidays.

    Providers can call Provider Relations for:

    • Credentialing
    • Provider contracts
    • Name change
    • Address change
    • NPI/TPI update
    • Phone and fax update
    • Billing company change
    • Letter of interest questionnaire

    If you need to file a complaint with the state, send an email to Provider Complaints.

    Nurse Advice Line 24/7

    Cook Children's Health Plan's Nurse Advice line is available to answer your health questions 24 hours a day, 7 days a week at no cost to you. 

    Our Nurse Advice Line staff can help you decide what kind of care to seek. You might be able to treat the condition at home, you might need to see your doctor, or you might need to get urgent or immediate care. The nurse line is staffed with registered nurses that understand pediatric care. The Nurse Advice Line staff speaks English and Spanish. If you speak another language and need an interpreter, just let them know and they will connect you with someone that speaks your language.

    The Nurse Advice Line can help:

    • Answer medical questions
    • Provide care advice and help you determine if you need help right away.
    • With medical conditions such as diabetes or asthma.
    • If you don't know how much medicine to give your child

    If you have a life-threatening medical emergency, call 911.

    Behavioral health- substance abuse services

    Cook Children’s Health Plan has arranged for confidential mental health and drug or alcohol abuse services by Beacon Health Options. You do not need a referral to get these services. They are available 24/7. If you have a life-threatening condition or behavioral health crisis, go to the nearest emergency room or call 911.

    They have bilingual staff in English and Spanish and also interpreter services for other languages free of charge. 

    Vision services (National Vision Administrators, LLC)

    Members can get a vision exam and one pair of lenses and a frame once every 12 months. You do not need a referral from your child's Primary Care Provider to see the eye doctor. Your child can get eye care from any NVA vision provider.

    Members can call National Vision Administrators, LLC. (NVA) for vision services.

    Dental managed care plans

    There are two dental plans that service children on CHIP or Medicaid. Your dental plan includes statewide coverage and great benefits for you or your child. Among the care that is covered is:

    • Basic care like check-ups, cleanings and X-rays
    • Preventive care like fluoride treatments and sealants
    • Other teeth problems like fillings, crowns, root canals and tooth removal

    DentaQuest

    MCNA

    United Health Care Dental

    Dental Value Add for pregnant women

    Cook Children's Health Plan offers Up to $250 for basic and major dental services for CHIP Perinate members enrolled in the Cook Children’s Health Plan’s Baby Steps Program.

    Liberty Dental:

    Medicaid Managed Care Program Helpline (Ombudsman)

    The Office of the Ombudsman is designed to help people already on Medicaid but need help getting health care services. A priority is placed on people with urgent or complex health care needs get help that includes:

    • Information about the Member's coverage
    • Guidance on how to get services
    • Referrals to the right place to get help
    • Direct help from their staff to help resolve a problem

    The hours of operation are Monday to Friday from 8a.m. to 5p.m.

    For mail:

    Texas Health and Human Services Commission
    Office of Ombudsman, MC H-700
    P O Box 13247
    Austin, TX 78711-3247
    Website: Ombudsman

    Fair hearing contact information

    If you would like to file a request for a State Fair Hearing, call us and we will help you get the process started.

    If you have any questions, please call Member Services at 1-800-964-2247 or Provider Services at 1-888-243-3312 Monday through Friday from 8 a.m. to 5 p.m.


    STAR KIDS

    Mailing Address

    Cook Children's Health Plan
    P.O. Box 2488
    Fort Worth, TX 76113

    Customer Care Department

    The hours of operation are 8 a.m. to 5 p.m. Monday through Friday, except for state holidays. If you call after 5pm or the weekend or holiday, leave a message and your call will be returned the next business day.Call our Customer Care Department for:

    • Pharmacy questions
    • PCP changes
    • New member ID card
    • Benefit questions

    All of our Customer Care Representatives are bilingual in English and Spanish. If you need a face-to-face interpreter to go with you to your appointment, please call us to schedule one.

    Emergency care

    Conditions that need immediate attention and without it you think will cause serious harm or jeopardy to your health are considered emergency care. If you have a life-threatening condition or behavioral health crisis, go to the nearest emergency room or call 911. You do not need a referral for emergency care. For a behavioral health crisis call Beacon Health Options at 1-855-481-7045.

    Member Advocates

    Cook Children's Health Plan has Member Advocates are ready to help you get the care you need and to make sure that you are treated fairly. They work closely with all departments within Cook Children's Health Plan and can help you solve any problems you have with your benefits, your provider or Service Coordinator. They can also help you:

    • Schedule an appointment, including care for urgent conditions
    • Understand and maximize benefits
    • Resolve billing issues with providers
    • File a complaint if you are not satisfied with the care you receive or had a service denied
    • Find resources within the community
      • Toll Free: 1-844-843-0004
      • TTY/TDD: 7-1-1
      • Toll Free TTY/TDD: 1-800-735-2988

    Service coordination

    Service coordination is a service Cook Children's Health Plan provides for you. You and your Cook Children's Health Plan Service Coordinator will work together to find out what your health needs are.

    With their help, you will also create a care plan, arrange all your services, and keep track of your progress toward your health care goals. When you enroll with Cook Children's Health Plan, you will be assigned to a Service Coordinator team that will help you with all your needs.

    You can call your Service Coordinator team if you have their direct number or by calling Cook Children's Health Plan at 1-844-843-0004. They will connect you to your Service Coordinator.

    Pharmacy

    Healthy members are very important to us. We are here to answer your questions to make sure your prescription benefit program works for you. This is your benefit and we want you to have convenient access to information that helps you manage your health.

    Use our Navi-Gate for Members Web Portal to access information about:

    • General pharmacy benefit information
    • Formulary
    • Pharmacy search
    • Drug search
    • Drug recall notifications
    • Easy access to direct member reimbursement (paper) claim forms

    Members call:

    • Toll Free: 1-844-843-0004
    • Local TTY/TDD: 7-1-1
    • Toll Free TTY/TDD: 1-800-735-2988
    • Member/Provider website: Navitus

    For Pharmacies and Prescribers only:
    Toll free: 1-877-908-6023.

    The hours of operation are 8 a.m. to 5 p.m. Monday through Friday, except for state holidays. If you call after 5pm or the weekend or holiday, leave a message and your call will be returned the next business day. All of our representatives are bilingual in English and Spanish.

    Provider Relations

    • Toll Free: 1-888-243-3312
    • TTY/TDD: 7-1-1
    • Toll Free TTY/TDD (hearing impaired): 1-800-735-2988

    The hours of operation are 8 a.m. to 5 p.m. Monday through Friday, except for state holidays.

    Call Provider Relations for:

    • Credentialing
    • Provider contracts
    • Name change
    • Address change
    • NPI/TPI update
    • Phone and fax update
    • Billing company change
    • Letter of Interest Questionnaire

    If you need to file a complaint with the state, send an email to Provider Complaints.

    Nurse Advice Line 24/7

    Cook Children's Health Plan's Nurse Advice line is available to answer your health questions 24 hours a day, 7 days a week at no cost to you. 

    Our Nurse Advice Line staff can help you decide what kind of care to seek. You might be able to treat the condition at home, you might need to see your doctor, or you might need to get urgent or immediate care. The nurse line is staffed with registered nurses that understand pediatric care. The Nurse Advice Line staff speaks English and Spanish. If you speak another language and need an interpreter, just let them know and they will connect you with someone that speaks your language.

    The Nurse Advice Line can help:

    • Answer medical questions
    • Provide care advice and help you determine if you need help right away.
    • With medical conditions such as diabetes or asthma.
    • If you don't know how much medicine to give your child

    If you have a life-threatening medical emergency, call 911.

    Non Emergency Medical Transportation (NEMT) - Access2Care

    If you need non-emergency transportation to your health care appointments, Access2Care can help arrange those services for you. They have bilingual staff that speak English and Spanish and interpreter services for other languages free of charge. Access2Care is available 24 hours a day, seven days a week. Members need to call at least 2 business days before their appointment.

    • Toll Free: 1-844-572-8195
    • TTY: 7-1-1 or 1-800-735-2988
    • Where's My Ride: 1-844-572-8195
    • Website: Access2Care

    Behavioral health- substance abuse services

    Cook Children’s Health Plan has arranged for confidential mental health and drug or alcohol abuse services by Beacon Health Options. You do not need a referral to get these services. They are available 24/7. Beacon also has Service Coordinators available for STAR Kids members. If you have a life-threatening condition or behavioral health crisis, go to the nearest emergency room or call 911.

    • Toll-free: 1-855-481-7045
    • TTY/TDD (hearing impaired): 1-855-539-5876
    • Member website: Beacon

    They have bilingual staff in English and Spanish and also interpreter services for other languages free of charge. 

    Vision services (National Vision Administrators, LLC)

    Members can get a vision exam and one pair of lenses and a frame once every 12 months. You do not need a referral from your child's Primary Care Provider to see the eye doctor. Your child can get eye care from any NVA vision provider.

    Members can call National Vision Administrators, LLC. (NVA) for vision services.

    Dental managed care plans

    There are two dental plans that service children on CHIP or Medicaid. Your dental plan includes statewide coverage and great benefits for you or your child. Among the care that is covered is:

    • Basic care like check-ups, cleanings and X-rays
    • Preventive care like fluoride treatments and sealants
    • Other teeth problems like fillings, crowns, root canals and tooth removal

    DentaQuest

    • Toll-Free: 1-800-508-6775
    • TTY/TDD (hearing impaired): 7-1-1
    • Website: DentaQuest

    MCNA

    • Toll-free: 1-800-691-6262
    • TTY/TDD (hearing impaired):1-800-955-8771
    • Website: MCNA

    United Health Care Dental

    Dental Value Add for pregnant women

    Cook Children's Health Plan offers Up to $250 for basic and major dental services for pregnant members enrolled in the Cook Children’s Health Plan’s Baby Steps Program.

    Liberty Dental:

    • Toll-Free: 1-888-902-0349
    • TTY/TDD: 1-866-222-4306
    • Website: Liberty Dental

    Medicaid Managed Care Program Helpline (Ombudsman)

    The Office of the Ombudsman is designed to help people already on Medicaid but need help getting health care services. A priority is placed on people with urgent or complex health care needs get help that includes:

    • Information about the Member's coverage
    • Guidance on how to get services
    • Referrals to the right place to get help
    • Direct help from their staff to help resolve a problem
      • Toll-Free: 1-866-566-8989
      • TTY/TDD: 1-800-735-2989

    The hours of operation are Monday to Friday from 8a.m. to 5p.m.

    For mail:

    Texas Health and Human Services Commission
    Office of Ombudsman, MC H-700
    P O Box 13247
    Austin, TX 78711-3247
    Website: Ombudsman

    To Submit a complaint to the office of the Ombudsman click here

    Fair hearing contact information

    If you need help, your Service Coordinator or a Member Advocate can help you file a request for a State Fair Hearing. Call us and we will help you get the process started.

    • Toll Free:1-844-843-0004
    • Toll Free TTY/TDD: 1-800-735-2988

    If you have any questions, please call Member Services at 1-844-843-0004 or Provider Services at 1-888-243-3312 Monday through Friday from 8 a.m. to 5 p.m.