Texas CHIP Plan
Sendero participates in the Children's Health Insurance Program (CHIP), including CHIP Perinatal (CHIP-P). CHIP is a health insurance plan for
children under the age of 19 and is designed for families who earn too much money to qualify for Texas Medicaid programs, yet cannot afford to buy
private insurance. CHIP-P provides prenatal care for the unborn children of low-income women who do not qualify for Medicaid.
Texas STAR Plan
Sendero participates in the State of Texas Access Reform (STAR) Managed Care Program (Medicaid). As a part of Medicaid, Sendero provides both Children’s
Medicaid and Medicaid for Pregnant Women. These programs are at no cost to U.S. residents who cannot afford health insurance.
Member Services 1-844-872-0537, M – F 8 AM – 5 PM.
Use the hospital emergency room only for emergencies.
If there is an emergency or crisis, go to the ER or call 9-1-1.
Please feel free to call or write us if you have any questions. We have special services for people who have trouble reading, hearing, seeing, or speak a language other than English or Spanish. If you need information in a different language, in audio form, larger print, or Braille, let us know and we will get it to you. Just call Sendero Member Services at 1-844-872-0537 as soon as possible. Sendero will give these materials to you at no cost.
Order or Replace your Sendero Health Plans ID Card Call Sendero’s Member Services Department at 1-844-872-0537 anytime Monday through Friday 8- 5 pm, and request a new identification card. We will mail you your new identification card the next day.
Prescription, Vision, and Dental Benefits Information
To lookup a specific drug click here.
24-Hour Nurse Help Line
How can I Access Behavioral Health or Substance Abuse Services?
Beacon Health Options
If you need to speak to a Customer Service Representatives to about your benefits, how to get care, or any other questions or concerns. We have bilingual Customer Service Representatives that can help you. Our Customer Service Representatives speak English and Spanish. We also offer over the phone interpreters in other languages. When you call us, you can ask to talk to someone in the language you speak. The services are free. If you need help with your benefits or have questions on how to get care or services please call us.
If you need face-to-face interpreter assistance for your doctor’s appointments, call Sendero Customer Service toll-free at 1-844-872-0537. For face-to-face services you will have to call at least 48 hours before your appointment.
How To File A Complaint and / or Complaint Appeal
For detailed instructions click here.
How to file an Appeal for Benefit Denial or Reduction
For detailed instructions click here.
Availability of Material in Alternate Formats
Information is available in English and Spanish. Call us to get an interpreter. Information can also be made available in audio, large print,
Braille or other languages, if needed.
State Fair Hearing Information
If you disagree with Sendero’s decision, you have the right to ask for a State Fair Hearing from the Health and Human Services Commission (HHSC). You may represent yourself at the fair hearing, or name someone else to be your representative. This could be a doctor, relative, friend, lawyer, or any other person. You may name someone to represent you by writing a letter to Sendero Health Plans telling them the name of the person that you want to represent you.
You or your representative must ask for a State Fair Hearing within 120 days from the date on the Sendero appeal decision letter. If you do not ask for the fair hearing by this date, you may lose your right to a fair hearing. You also have the right to request a State Fair Hearing if Sendero does not make a decision on your appeal request within the required timeframe. To ask for a fair hearing, you or your representative should write or call Sendero at:
Sendero Health Plans
If you believe that waiting for a fair hearing will put your life or health at risk you or your representative may ask for an expedited fair hearing by writing or calling Sendero. To qualify for an expedited fair hearing through HHSC, you must first complete Sendero’s internal appeals process.
If you ask for a fair hearing within 10 days after the date of the appeal decision letter you may be able to keep getting any service or benefit that is being terminated, suspended, or reduced by Sendero, at least until the final hearing decision is made. If you do not request a fair hearing by this date, the service or benefit will be terminated, suspended, or reduced. If you lose your fair hearing appeal, Sendero may be able to recover the costs of providing the service or benefit to you while the appeal was pending. If you ask for a fair hearing, you will get a packet of information letting you know the date, time and location of the hearing. Most hearings are held by telephone. You can also contact the HHSC hearings officer if you would like the hearing to be held in-person. During the hearing, you or your representative can tell why you need the service or why you disagree with the Sendero’s action.
You have the right to examine, at a reasonable time before the date of the fair hearing, the contents of your case file and any documents to be used by Sendero at the hearing.
Before the hearing, Sendero will send you all of the documents to be used at the hearing.
HHSC will give you a final decision within 90 days from the date you asked for the hearing.
Member Advisory Group
Would you like to get more involved with your health plan? Sendero is looking for members to join the Member Advisory Committee. This committee will give Sendero ideas and feedback from a member’s point of view. Call us toll-free at 1-844-872-0537 to learn more.
Provider Services and Provider Relations Contact Information
Monday through Friday 8 AM - 5 PM
For more information on joining the Sendero network, please email us at firstname.lastname@example.org or click here to download a provider interest form.
You may also call our Network Management team at 1-855-895-0475.
Email email@example.com to request an in-office training by a Sendero Provider Representative. Please include in the request any special topics that you would like more information about from Sendero.