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About RightCare

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Here’s your go-to guide for RightCare

 

Filled with useful information, your member handbook helps you get the care you need. Read through to learn all about your benefits. It’s pretty handy to have, especially if you don’t always have Internet access. Inside you’ll find:


Download RightCare Member Handbook


RightCare Member Handbook Table of Contents


If you need this book in a different format such as audio, large print, braille, or in a language other than English and Spanish, call RightCare Member Services.




Member Information

  • Replacement ID Card — If you lose your RightCare STAR Medicaid ID Card, call us right away at 1-855-897-4448 to get a new one. If you don’t have the card, you can still go to the doctor, clinic, or hospital. You might have to wait for services while your RightCare membership is checked.
  • Notice of Privacy Practices — For information on how medical information about you may be used and disclosed and how you can get access to this information use the Notice of Privacy Practices.

  • Member Advisory Group — You can help RightCare with the way our health plan works. We have a Member Advisory Group that gives members like you a chance to share your thoughts and ideas with RightCare. At the meetings, you will have a chance to talk about the way services are delivered. The Member Advisory Group will meet four (4) times a year. We ask members, community representatives, advocates and member of RightCare’s staff to join in the meeting. This gives you a chance to talk about your concerns with a variety of people. You also have a chance to tell us how we are doing. You may ask questions or share any concerns that you have about the delivery of services. Call RightCare Member Services at 1-855-897-4448 if you would like to be on this team.

HHSC Notification Area

  • Mosquito Repellent Is Available as a Statewide Benefit — Texas covers certain mosquito repellent products for the prevention of Zika virus as a benefit in Medicaid and other state programs. Learn more.
  • Member Fraud Notice


Provider Directory

  • Members can choose a PCP by calling Member Services at 1-855-897-4448. RightCare’s Provider Directory lists all in-network PCPs. You may ask for one to be mailed to you by calling Member Services at 1-855-897-4448. You may also view the Provider Directory by viewing this link.
  • Specialty Providers Referrals — Referrals are needed to see most RightCare specialty provider. A referral is an approval from your PCP for you to get specialty care and follow up treatment. If you receive services from a specialist without your PCP’s referral, or if the specialist is not a RightCare provider, you might be responsible for the bill. You can get some services without going to your PCP first. These include:
      • 24-hour Emergency Care (if you feel you have a true medical emergency)
      • Routine Vision Care
      • Dental Services (for children)
      • OB/GYN Care
      • Family Planning Services and Supplies
      • Behavioral (Mental) Health and Substance Abuse Services
      • Texas Health Steps


Medicaid Appeals Process

   You can appeal a decision if Medicaid covered services are denied based on lack of medical need.


Complaints Process

   If you have a complaint, please call us toll-free at 1-855-897-4448 to tell us about your problem. 


File a Complaint