These forms and documents are available as PDF files. Just click on a form or document to download it. To view these files, you may need to install a PDF reader program. One option is Adobe® Reader®; this can be downloaded free of charge at Adobe's site.
Handbook and Directories
If you need a printed copy of our member handbook, provider directory or other materials that will help you better understand your benefits, please call Customer Service. Your request will be fulfilled at no cost within five business days.
STAR Member Handbook
Provider Directory
Pharmacy Directory
Dental Provider Directory (adult STAR members only)
Forms
Appeal Request Form
Complaint Form
Fair Hearing Request Form
Prenatal Incentive Options (Car Seat or Pack and Play) Form
Prescription Drug Claim Form
Mail Service Registration and Prescription Order Form
Primary Care Provider (PCP) Selection Form
Request to Access PHI Form
Value-Added Services and Program Brochures
Blue Access for MembersSM Brochure
Value-Added Services Brochure
Transportation Benefit Brochure
Service Coordination Brochure
Farmworkers Brochure
Special Beginnings Brochure
Value-Added Dental Services Brochure
LifeTimes® Newsletter
Summer 2024
Spring 2024
Winter 2024
Fall 2023
Important Notices
Annual Notices
HIPAA Notice of Privacy Practices
Your Rights for an Appeal of an Adverse Determination
Find additional prescription drug forms.
Additional Resources
Texas Health and Human Services Commission
Texas Department of State Health Services
Texas Department of Family and Protective Services
Texas Department of State Health Services, Women, Infants, and Children Program (WIC)
Texas Juvenile Justice Department
Children Advocacy Centers of Texas, Inc.
Your Texas Benefits, from the Texas Health and Human Services Commission
Healthy Texas Women
Coronavirus (COVID-19) Information for Medicaid and CHIP Members