We have a large network of doctors, hospitals, and specialists who are committed to providing you with good medical care. Our health plan was founded on the belief that you and your primary care provider (main doctor) are the 2 best qualified to care for your health. Think of your main doctor as your medical home. If you are sick, need a checkup, or if you have a medical question, call your main doctor.
Your primary care provider will give you all your routine medical care and will refer you to a specialist or hospital when needed. A referral is when your primary care provider arranges for you to go to another doctor. He or she will tell you exactly what kind of specialist or tests you need for your illness or condition.
Most of the time, you will need to go to your primary care provider first. If you choose to go to another doctor, you might have to pay for the services. Remember—always take your Texas Children’s Health Plan ID card and Your Texas Benefits Medicaid Card with you each time you get health care.
Services that do not need a referral from your/your child’s primary care provider
There are certain types of health care that you/your child can get without being referred by the primary care provider:
Those services include, when given by a Texas Children’s Health Plan network provider:
- Emergency care
- Vision care
- Mental health or drug abuse treatment
- Obstetrical/gynecological (OB/GYN) care, including routine exams, prenatal care, and postpartum care.
- Chiropractor care
To pick a main doctor, you can use our online “Find a Doctor” tool here, or you may click on one of the following links to open our provider directory. If you need help or have questions, please call Member Services.
Find a Doctor
If you can’t find your doctor or if you need help, call Member Services toll-free at 1-866-959-6555 (CHIP).