Frequently Asked Questions (FAQs) - MEDICAID/CHIP EXIT
You may have heard that Sendero Health Plans (SHP) will be exiting STAR and CHIP in the Travis Service Area effective May 1, 2018. We want you to know that it has been an honor to provide your health insurance coverage, and we have enjoyed the opportunity to work with you and your Providers in helping you and your family get the care you need.
What happens next? Will I lose my insurance?
No. Sendero will continue covering your care through April 30, 2018. Your new plan will become effective on May 1, 2018.
What do I need to do to keep my coverage?
By April 13, 2018, you will have to choose another health plan. The other health plans in this area are:
You can choose another health plan by calling The Health and Human Services Commission’s (HHSC) Enrollment Broker at 1-800-964-2777 no later than April 13, 2018.
What happens if I don’t choose another health plan?
If you do not choose a new health plan by April 13, 2018, a health plan will be chosen for you by the Enrollment Broker.
What if I need to go to the doctor or fill prescriptions?
Sendero will continue to cover your care through April 30, 2018. You can still use your Sendero ID card to see your doctor or fill prescriptions until midnight on the 30th.
What if I have services scheduled after the termination date?
If you have services scheduled after the termination date, you will need to contact your new health plan to see if authorizations are required.
What if I get my prescriptions by mail or delivered at my home?
If you are receiving mail order prescriptions or if prescriptions are being delivered to your home, you will need to sign up for those services with your new health plan.
Who do I call if I get a bill from my doctor?
Call Sendero’s Customer Service at 1-844-872-0537 and give them the doctor’s name, phone number and the date for the service you are being billed.
What if I have a complaint after the termination date?
Call Sendero’s Customer Service at 1-844-872-0537 and tell them what your complaint is about. Sendero will process your complaint and provide a resolution no later than the 30th day the complaint was received.
What do I do if I get a bill?
You should never get a bill from your PCP or doctor. If you get a bill from a doctor, call at Sendero Customer Service toll-free at 1-855-826-7388, and we will call the provider’s office. We will help explain your benefits.
What if I want to appeal a denial of an authorization?
Call Member Services at 1-844-872-0537 for more information.
How do I get my value added services?
For any questions about your previously submitted value added service or to submit a new request for value added services (extra benefits), please contact Sendero Member Services toll-free at 1-844-872-0537.
What if I want to keep my same doctor?
Please contact the Health and Human Services Commission’s (HHSC) Enrollment Broker at 1-800-964-2777 to see if your new plan has your doctor in their current network. You may also call your doctor or specialists to find out which plans they accept.
What do I do if I am pregnant? Can I keep my doctor that is providing my pre-natal care?
If you are past the 24th week of pregnancy you may continue to see your current pre-natal doctor under your new plan through the post-partum checkup. Contact your new plan so they can assist you with coordinating care.
What if my glasses or frames break?
Through April 30th you can contact Envolve Benefit Options toll free at 1-877-615-7730. After April 30th you will need to contact your new health plan for their assistance.
What if I need a ride to a doctor’s appointment?
If you are a STAR member, please contact the Medical Transportation Program at 1-877-633-8747. If you are a CHIP member, please contact Sendero Health Plans prior to the termination at 1-844-872-0537. After the termination date contact your new health plan.