Texas has many healthcare programs that provide medical and long term care
benefits for qualified residents. The purpose of these programs is to improve
the health of people who might otherwise go without medical care for themselves
and their children.
For more information about specific programs, visit any of the links below:
Medicaid Overview
Medicaid is the State and Federal cooperative venture that provides medical
coverage to eligible needy persons. The purpose of Medicaid in Texas is to
improve the health of people who might otherwise go without medical care for
themselves and their children. The Texas Health and Human Services Commission's
(HHSC) Medicaid Office is responsible for statewide oversight of the Texas
Medicaid program.
Your Health Care Guide - 2012 Edition
Medicaid Contact Information
For information on Texas Medicaid, including eligibility, enrollment, and
coverage please visit the
HHSC Texas Medicaid Program website.
You may also call, toll-free:
- Medicaid Client Hotline: (800) 252-8263
You may also visit the
Centers for Medicare & Medicaid
Services (CMS) website.
If you are a Medicaid provider looking for specific
information about the Medicaid, Children with Special Healthcare Needs (CSHCN),
Family Planning, Texas Health Steps (THSteps) or other programs, visit the
TMHP Medicaid provider page.
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Family Planning Overview
The Texas Department of State Health Services Family Planning Division (DSHS
FPD) provides services for preventive health, medical services, counseling
services, and educational services that assist individuals in managing their
fertility and achieving optimal reproductive and general health. TMHP processes
Family Planning claims and encounters for four different funding sources. The
funding sources are categorized as Program 100 (Title XIX, Medicaid) and Program
300 (Titles V, X, and XX). For more information about the DSHS FPD and becoming
a client, visit the
DSHS
client site for the Family Planning Division.
Family Planning Contact Information
- DSHS Family Planning Preventive and Primary Care Unit: 1-512-458-7796
- TMHP Family Planning Sterilization Form Fax line: 1-512-514-4229
- Automated Inquiry System (AIS) line: 1-800-925-9126
Family Planning Helpful Links
If you are a Family Planning provider looking for specific
information about Family Planning, visit the
TMHP Family
Planning provider page.
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Long Term Care Programs Overview
The Department of Aging and Disability Services (DADS) was created to
administer long-term services and supports for people who are aging and who have
cognitive and physical disabilities. DADS also licenses and regulates providers
of these services, and administers the state’s guardianship program. DADS began
formal operations on Sept. 1, 2004.
The TMHP Long Term Care (LTC) department supports the provider
community as they submit forms and assessments through the LTC Online Portal
and claims for services rendered through the Claims Management System
(CMS).
TMHP offers support through determination of medical necessity and
level of care for clients who are Medicaid eligible and meet the medical
necessity requirements of admission into a nursing home or a cost-effective
alternative to institutionalization. The LTC Help Desk provides
customer-oriented support to providers and State staff regarding submissions of
LTC forms, assessments and claims.
For more information about Long Term Care or Nursing Facilities Policy,
visit the
Texas Department of Aging and Disability Services LTC Policy website.
If you are a LTC Programs provider looking for specific information
about LTC, visit the TMHP Long Term Care Programs
provider page.
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Texas Health Steps (THSteps) Overview
The Texas Health Steps program or THSteps, formerly known as Early and
Periodic Screening, Diagnosis and Treatment (EPSDT), is a program under Medicaid
which gives medical and dental checkups and care to children from birth to 21
years old who are enrolled in Medicaid.
The THSteps program assists eligible recipients and their parents or
guardians to:
- Find a doctor or dentist for the client;
- Set up appointments to see a doctor or dentist;
- Arrange transportation or reimbursing gas money to see a doctor or
dentist
- Answer questions about eligible services.
THSteps Contact Information
THSteps Helpful Links
If you are a THSteps provider looking for specific information about
THSteps, visit the
TMHP THSteps provider page
.
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