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Do more for your family with RightCare's extra member benefits

Explore Extra Member Benefits

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Make your Voice Heard at the RightCare's Member Advisory Group

You are invited to an online RightCare's Member Advisory Group

Wednesday, Nov. 30, 2022, at 1:45 p.m.

Reserve your spot online or call 800-431-7798

Physician/Provider Advisory Group Meeting

Scott and White Health Plan and FirstCare Health Plans would greatly appreciate your attendance at the virtual Physician/Provider Advisory Group (PAG) Quarterly Meeting Wednesday, Dec. 14, 2022, from 3 to 4 p.m. (CT).

To RSVP and request a calendar invite please contact Paul Kuder (Paul.Kuder@bswhealth.org) or Denese Montes (Denese.Montes@bswhealth.org).

Support for the Uvalde Crisis

We extend our deepest condolences to everyone affected by the tragic events in Uvalde. If you are a member needing support, we're here to help.

Attention: Members Impacted by Natural Disaster Events

We're here to help! Impacted RightCare members are encouraged to visit RightCare.swhp.org/Disaster for updates & information. Contact RightCare Member Service for assistance accessing medical care and/or services.

Similac Baby Formula Voluntary Recall

Please visit the Abbott website for more information about the voluntary recall of specific Similac products.

Did you know you can change your primary care doctor on our member portal?

Click here for more information.

COVID-19: What you need to know about the outbreak of the coronavirus

We care about the health and well-being of all of our members—as we continue to monitor the spread of COVID-19, we are committed to keeping you informed.

Click here for the latest COVID-19 information and how to visit with a doctor by phone or video.

Click here for Texas Health and Human Services (HHS) help.

Click here for COVID-19 Vaccine Facts.

Meet the Grow WellTM app, available now to RightCare members at no charge.

It’s your one place to find trusted health information for you and your family through every age and stage of life. Plus, you can directly connect to resources. Learn more.

Extra Help: STAR

We would like to let you know of several new benefits available at no charge to members that qualify.

Applied Behavior Analysis (ABA) Services:

Starting Feb. 1, 2022, RightCare from Scott & White Health Plan (RightCare) will be providing Applied Behavior Analysis (ABA) services as a new Medicaid managed care benefit for members with Autism Spectrum Disorder (ASD). Autism spectrum disorder (ASD) is a condition characterized by restricted, repetitive patterns of behavior, interests, or activities and deficits in social communication and social interaction, with onset of symptoms occurring in early childhood.

 

What Services are provided?
ABA services must be approved through RightCare as a medically necessary service, required to treat, correct, or improve the member's condition. A diagnosis of autism spectrum disorder alone does not support the medical necessity of ABA. Licensed Behavior Analyst (LBA) is a new Medicaid provider type that will be providing these services. ABA services include ABA initial evaluation, re-evaluation, individual treatment, group treatment, parent/caregiver/family education and training, and collaborative team meetings. Please contact your/your child’s doctor, visit RightCare’s website, or call Member Services at 855-897-4448 to help find an in-network Medicaid LBA provider.

ATTENTION: PHONE LINES OPEN – OFFICES CLOSED TO MEMBERS

Following guidelines, for a limited time, we do not have in-person customer service. We will be happy to help you by phone by calling 1-855-897-4448, 7 a.m. to 7 p.m. CT weekdays.

You also have access to the portal. The portal gives online access to:

  • Find a doctor or pharmacy
  • Choose or update your PCP
  • Print a temporary ID card
  • Ask for new ID card
  • Update your personal information
  • Review your Member Handbook

Visit rightcare.firstcare.com to set it up today.

Medicaid will automatically renew benefits

Due to the COVID-19 pandemic, SNAP and Medicaid recipients will have their benefits renewed automatically. No further action is necessary, and recipients will be notified by mail when it is time for them to renew their benefits. yourtexasbenefits.com.

Notice to Scott and White Health Plan RightCare Members: Emergency Medical Care

Click here for details.

Your Texas Benefits

Coverage for Medicaid recipients will continue during the public health emergency. Medicaid recipients who no longer meet the criteria for their current type of Medicaid coverage may be moved to another type of Medicaid coverage. Medicaid recipients will be notified if their coverage is changing and if they need to take any action. Click here to learn more.

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Program Overview

RightCare from Scott and White Health Plan provides STAR Medicaid services in the Medicaid Rural Service Area – Central Texas. STAR is managed care Medicaid. You pick a medical plan that provides your Medicaid services and a main doctor that is your point of contact for Medicaid services. In addition to your main doctor, each plan has a large group of specialists, therapists, clinics, and hospitals that can provide you with Medicaid services.

Texas Health and Human Service - Texas STAR

Background

Scott and White Health Plan and Insurance Company of Scott and White (SWHP) started operations in January 1982 as a nonprofit Health Maintenance Organization. Since then, our mission has been: "To provide the most personalized, comprehensive, highest quality health care, enhanced by medical education and research." SWHP was first called Centroplex Health Plan, and our service area was focused primarily in Bell and Coryell counties. Since then, we've grown our membership to more than 240,000 members and our service area to 80 counties in the Central, East, North, and West Texas regions. New insurance plans, including self-insured plans, a Medicare prescription plan, and a Medicaid plan, have been introduced to meet the needs of members, employers, and the community.

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Enjoy full Medicaid benefits with RightCare, plus so much more

Health, Dental & Vision Benefits

Gift Card Programs

Rides to Providers

24/7 Telehealth Doctors Through MDLIVE


Drawing upon the rich history of service and high-quality care provided throughout the Baylor Scott & White Healthcare network, RightCare offers Medicaid families in Texas everything children and pregnant moms need to be healthy. This includes all of the services covered by the Texas Medicaid program, STAR, plus these additional benefits and services.

Become a Member

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Our RightCare network puts you closer to the providers your family needs

Find a Provider

4,200+

Doctors & Specialists

200+

Pharmacies

40+

Hospitals & Clinics

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Availability of Materials in Alternate Formats

If you need any RightCare materials in a different format such as audio, large print, braille, or in a language other than English and Spanish; contact RightCare Member Services.

Office of Inspector General (OIG) Website Link:

Report Waste, Abuse, or Fraud to the Inspector General

Member Support

Member Services

If you have questions, call us at 1-855-TX-RIGHT. Our staff is bilingual in English and Spanish. If you speak another language or are hearing impaired, call Member Services at 1-855-TX-RIGHT (TTY 711) for help.

Regular Business Hours: Monday to Friday, 7 a.m. to 7 p.m. Central Time (except for state-approved holidays). If a medical condition is life-threatening, members should go to the emergency room. If the medical condition is non-life-threatening you can seek care at an urgent care facility or get urgent medical care from your primary care provider (PCP) within 24 hours.

If you call after hours, please leave us a message. We return all calls the next business day.

You can also visit the 24/7 Member Portal or send a Secured Message in Member Portal.

Provider Services Hotline

If you have questions, call us at 1-855-TX-RIGHT. Regular Business Hours: Monday to Friday, 8 a.m. to 5 p.m. Central Time (except for state-approved holidays). Provider can call to verify eligibility and claim inquiries.

Behavioral Health Hotline Number

If you need mental health or substance abuse services, you can call a Behavioral Health Case Manager at 1-855-395-9652. Behavioral Health Services are private so you do not need permission from your PCP to get these services. If you are in crisis, you can call the behavioral health crisis line anytime 24 hours a day, 7 days a week, you will not get a recording. Our staff is bilingual in English and Spanish. If you need, we can arrange for an interpreter to help you. If a medical condition is life-threatening, members should go to the emergency room. If the medical condition is non-life-threatening you can seek care at an urgent care facility or get urgent medical care from your primary care provider (PCP) within 24 hours.

Need a Ride? Nonemergency Medical Transportation (NEMT)

  • Starting June 1,2021, we can help you or your child get a ride, at no cost, to the doctor, hospital, dentist, and drugstore.
  • Call us 48 hours before at 1-877-447-3101 (TTY 711) or download the Access2Care (A2C) app.
  • All you need is your ID number, provider’s name, and the address.
  • Click here to learn more.
  • Postcard Sample

STAR Program Help Line (Enrollment Broker)

1-800-964-2777 (TTY: 711). Regular Business Hours: Monday to Friday, 8 a.m. to 6 p.m. Central Time (except for state-approved holidays). The Texas STAR Program Help Line can help members change their address or phone number, or sign up their baby after birth.

Fair Hearing

If you, as a member of the health plan, disagree with the health plan’s decision, you have the right to ask for a fair hearing only after exhausting the MCO Internal Appeal System provided by RightCare. Members may ask for a State Fair Hearing by contacting us toll-free at 855-897-4448 (1-855-TX-RIGHT). RightCare’s Member Services can help you file a fair hearing.

External Medical Review

If you, disagree with the health plan’s decision, you have the right to ask for a State Fair Hearing (standard or expedited) only after exhausting the RightCare Internal Appeals process or you can ask for a State Fair Hearing with an External Medical Review (EMR) (standard or expedited). You cannot only ask for an External Medical Review. An EMR is an optional, extra step for the member to have a case outside the Hearing, free of charge. To request an EMR, call us at 1-855-897-4448.

Updated Information on EMR added to Appeals and Complaints Process page (linked off Member Homepage)

Appeals Process (linked off Member Homepage)

Subcontractor Information

RightCare uses the following subcontractors to provide members and providers the best experience:

Office of Consumer Credit Commissioner

Click here.

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Language Center

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-855-897-4448 (TTY: 711).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-855-897-4448 (TTY: 711).

View our multi-language assistance and non-discrimination notices.

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  • The National Committee for Quality Assurance (NCQA) awarded Scott and White Health Plan an Accredited Status (Medicaid certified 03/2021) - reflecting our continuous work to fulfill NCQA requirements for consumer protection & quality improvement.

RightCare — the extra care Medicaid members deserve

Become a Member