Your Texas Benefits Medicaid Card Questions and Answers: Stakeholders

Who gets the Your Texas Benefits Medicaid card?

• Texans who have applied for Medicaid will get the card in the mail shortly after they’ve been approved for services. The card shows the person’s Medicaid ID number and the person’s medical and dental plans, if they are in a Medicaid managed care program. The back of the card has a magnetic strip that also holds the person’s Medicaid ID number, and information about the type of Medicaid program the person is in.

What will be included in the mailing?

• Each envelope will contain a card for each person in the home who has Medicaid coverage. Members will also get:
• Instructions on how to use the card.
• A graphic details explaining the information printed on each section of the card.
• A list of helpful phone numbers similar to what appears on the back of the current Medicaid ID (Form 3087).

Without a monthly letter, how will a person know if he or she has Medicaid coverage that month?

• A person can find out if they have coverage by calling a statewide toll-free number –
  800-252-8263. Or, they can call 2-1-1 (pick a language and then pick option 2).

Will the card guarantee services for the person who has it?

• No. A Medicaid provider needs to verify the member’s Medicaid coverage at the time of service.  Providers can use a new online portal designed for use with the new Your Texas Benefits Medicaid card.  Or, providers can continue to call the Texas Medicaid Healthcare Partnership (TMHP) at 1-800-925-9126 or go to TexMedConnect on the TMHP website and checking the member’s Medicaid ID number (PCN).

What does a person do if they’ve lost their Your Texas Benefits Medicaid card and need proof of coverage before they can get a replacement card?

• A provider can verify a patient’s eligibility for Medicaid one of three ways: by checking the new provider website (after June 1), by calling 1-800-925-9126, or by visiting TexMedConnect on the TMHP website.

• If a member loses the Your Texas Benefits Medicaid card and needs quick proof of eligibility, HHSC staff can still generate a Temporary Medicaid Eligibility Verification Form (Form 1027-A). Members must apply for the temporary form in person at an HHSC benefits office. To find the nearest office call 2-1-1 (pick a language and then pick option 2).

Will children in foster care get a Your Texas Benefits Medicaid card?

• Children in Department of Family and Protective Services (DFPS) conservatorship will get a Your Texas Benefits Medicaid card to use for visits to the doctor, dentist, or drug store. Their health information will still be found in the Health Passport, just like it is now. The new card and the system it works with are designed to make sure each child’s private information is protected.

Does everyone who has Medicaid benefits get a Your Texas Benefits Medicaid card?

• No. People who have Medicaid only through the Specified Low-Income Medicare Beneficiaries (SLMB) or Qualified Individuals (QI-1) programs do not get cards. The only Medicaid benefit people in these programs receive is payment of their Medicare Part B premium. They do not need a card because they do not get other Medicaid services.