Parkland HEALTHfirst is a managed care health plan offering services for people on STAR (Medicaid), making it easy for you to get quality care for you and your family.
Parkland HEALTHfirst STAR Medicaid
Parkland HEALTHfirst Medicaid is a managed care health plan that offers services for you.
Choose from a network of more than 9,000 doctors and specialists. We also have over 40 hospitals and urgent care centers in our network.
The hospitals in the Parkland HEALTHfirst Medicaid network include Parkland Hospital, Children’s Medical Center, and many more. Our network also includes several local health centers so you can find healthcare close to home.
Our list of doctors includes pediatricians, specialists, gynecologists, and doctors for routine checkups, immunizations, and more.
Parkland HEALTHfirst STAR Medicaid also offers health education programs about:
- Preventing and treating certain medical conditions
- Heart disease
- Prenatal care for pregnant women
- Programs to help you stop smoking
Frequently Asked Questions
We have special services for people who have trouble reading, hearing, or seeing, or speak a language other than English or Spanish.
Please call Member Services at 1-888-672-2277 (TTY 7-1-1) to contact interpreter services.
Once you have chosen Parkland Community Health Plan, your next step is to choose who will provide the majority of your healthcare services. Your primary care physician (PCP) will be the one you call when you need medical advice, when you are sick, and when you need preventive care such as immunizations. Each member may select his or her own PCP.
You will select a PCP from PCHP’s extensive network of family or general practitioners and pediatricians. The selection of a PCP is crucial for immediate access to acute and preventive care.
PCHP makes every effort to provide new members with ID cards as quickly as possible. During the time of enrollment processing, members and providers may verify eligibility through PCHP’s secure web portals.
Learn more about your ID card here.
If you go to the doctor’s office without your member ID card, you can tell them you’re with Parkland Community Health Plan. The doctor’s office will call us to verify your information.
You can also view your ID card on our member portal. Do your best to bring your card with you to every appointment.
As a STAR Medicaid member, you have access to the following extra benefits including:
- 24-Hour Nurse Line
- Extra vision benefits
- Extra dental benefits
- Free sports and school physicals
- Free cell phone*
- Car seats and home-delivered meals for pregnant women
- Member paid rewards programs
- And more…
*Included only in Parkland HEALTHfirst STAR Medicaid membership.
Limitations and restrictions apply for each value-added service.
Call us at 1-888-672-2277 to learn more about these and other benefits. You can also see all the rewards and track your reward points online.
You can access your secure member portal by using the Member Login link. This is a secure web portal where you can request an ID card, ask to change your PCP, file a complaint, or ask a question.
One of our main goals is to help you stay as healthy as possible. The HRA is one way we do this. It’s a series of easy questions about your health and lifestyle.
Filling out the HRA is easy - it should take less than 15 minutes to complete.
Log into your member portal and complete the "Children and Adults Health Survey" or "Pregnant Moms Health Survey".
There are some medications that may not be covered through Medicaid or CHIP. A pharmacy in the Navitus network can let you know which medications are not covered. The pharmacy can also help you find another medication that is covered. You can also ask your doctor or clinic about what medications are covered, and what is best for you.
The Texas Vendor Drug Program has a list of drugs on the Preferred Drug List (PDL). A drug that is covered by this PDL may be brand or generic. The provider is asked to look at the Vendor Drug Program website when prescribing medication and write for the preferred product.
If you need help with a problem or have a complaint, please call Member Services at 1-888-672-2277. You can also send a written complaint, or a Member Services advocate can write down your complaint for you.
Parkland Community Health Plan
Attention: Member Advocate
P. O. Box 560347
Dallas, TX 75356-9005
For more information on the process, timeframes, and next steps, visit our Complaints & Appeals page.
If you suspect a client (a person who receives benefits) or a provider (e.g., doctor, dentist, counselor, etc.) has committed fraud, waste, or abuse, you have a responsibility and a right to report it.
Fill out our fraud, waste, or abuse form, and submit it to us directly by:
- Mail: Parkland Community Health Plan
Attn: Special Investigations Unit
P.O. Box 560307
Dallas, TX 75356
- Phone: 1-800-403-2498
Available 24 hours a day, 7 days a week.
- Email: PCHPSIU@phhs.org
For more information, visit our Fraud, Waste, & Abuse page.
PCHP offers nonemergency medical transportation to all HEALTHfirst members. Members must use Access2Care to set up medical transportation at least two workdays before your appointment to schedule a trip. English/Spanish interpreter services available, TTY 7-1-1.
- Phone reservations: 1-833-931-3844 Mon-Fri, 8 am-5 pm (CT)
- Where’s My Ride: 1-833-931-3844 Mon-Sat, 5 am-7 pm (CT)
You or your child may be able to get free transportation to and from the doctor, dentist, hospital, drugstore, or other Medicaid service providers.
What do I need when I schedule a trip for myself or my child?
- Medicaid ID number of the person with the appointment
- Address of your pickup location
- Your phone number
- Name of the medical professional you or your child will be seeing
- Date and time of the appointment
- Any unique needs you may have, like using a wheelchair or walker, so the right vehicle can be sent
What is a prior authorization?
Under medical and prescription drug plans, certain medications may need approval from your health insurance carrier before they’re covered.
It is not a referral or a pre-authorization. Prior authorization is an approval that Parkland HEALTHfirst requires for certain services and medications. Some services need approval before they are given. The provider who is treating your child should get this approval. You can ask your doctor or us if an approval is needed for a service or treatment.
What types of medications typically need approval?
- Those that may be unsafe when combined with other medications
- Have lower-cost, equally effective alternatives available
- Should only be used for certain health conditions
- Are often misused or abused
- Drugs often used for cosmetic purposes
- Medications that require approval will only be covered by your plan if your doctor requests and receives approval from your health insurance company.
What’s the difference between prior authorization and pre-authorization?
None; these terms mean the same thing and are used interchangeably. However, most insurance companies will use the term “prior authorization” instead of “pre-authorization.”
How does the prior authorization process work?
Prior authorizations for prescription drugs are handled by your doctor’s office and your health insurance company. Your insurance company will contact you with the results to let you know if your drug coverage has been approved or denied, or if they need more information.
If you are unhappy with your prior authorization decision, you or your doctor can ask for a review of the decision, or your doctor may prescribe a different but equally effective medication. In some instances, your health insurance company may recommend you try an alternative medication that’s less costly, but equally effective, before the medication your doctor originally prescribed can be approved.
Learn more about Prior Authorization here.
What is a referral?
The doctor will talk to you about your/your child’s needs and will help make plans for you to see the specialist that can provide the best care for you. This is called a referral. A referral is not a requirement for your Parkland HEALTHfirst plan of benefits.
What services do not need a referral?
The Parkland HEALTHfirst STAR (Medicaid) plan of benefits does not require referrals for any services; however, there are services that may need prior authorization.
Call toll-free to talk to someone if you need help right away. You do not need a referral for mental health or substance abuse services.
CHIP Perinate: 1-888-814-2352
English/Spanish interpreter services available 24 hours a day, 7 days a week
PCHP now offers telehealth services at no cost for all HEALTHfirst and KIDSfirst members age 0-21. This includes easy, convenient access to pediatricians through a partnership with telehealth provider KidzDocNow. Members can talk to a provider from 7am to 11pm, seven days a week.
Telehealth is great for:
- Upset stomach and other digestive issues
- Cold and flu symptoms
- Prescription refills
- Questions about nutrition and exercise
- Questions about newborn health or breastfeeding
- Mental health concerns
To use telehealth services, visit KidzDocNow.com. You can also download the free mobile app for Android or iOS devices (search for “KidzDocNow” in the Google Play or Apple App store).
Texas Health Steps is the Medicaid health care program for children, teens, and young adults (birth through age 20). You can call Texas Health Steps at 1-877-847-8377 and visit the Texas Health Steps website for more information.
Regular Texas Health Steps checkups for babies and toddlers are done within five days after leaving the hospital, and at 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 24 months, and 30 months.
For older children, an easy way to remember when Texas Health Steps medical checkups are due is to schedule an appointment 60 days after their birthday.