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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

Prior Authorization List

STAR Medicaid Terms and Definitions

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

  • Changes to RightCare's Extra Member Benefits — Starting Sept. 1, 2019, RightCare has new and updated benefits for members.
    • 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.

    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