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Individuals & Families

Healthy Pregnancy Information

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Expecting the Best® Maternity Program

FirstCare Health Plans is pleased to offer Expecting the Best® for our members. This program is focused on helping mothers enjoy a healthy pregnancy. Expecting the Best® members will receive helpful tips and assistance during pregnancy and for one year after birth.

Pregnancy/Delivery
  • Planning for delivery, including individual support during and after a pregnancy
  • Access to a nurse 24 hours a day, seven days a week
  • Coordinated efforts to promote full-term birth in women who previously delivered pre-term
  • In-home support for high-risk conditions such as diabetes, hypertension and severe nausea
  • Early enrollment in service coordination support program
Postpartum
  • Depression screening following delivery, including postpartum resources
  • Parental education for newborn health during the first year
  • Immunization reminders
  • Planning for returning to work
Members may be contacted by a Service Coordinator to invite you to this program, when we receive a claim indicating pregnancy. You may also opt-in and sign up for this program by calling the customer service number on the back of your insurance card or email us. Please include:
  • Name
  • Preferred phone number
  • FirstCare member number
  • Brief description of your needs
A Service Coordinator may invite you to enroll when we receive a doctor’s referral or pregnancy claim. You can opt-in or out of this program at any time through a Service Coordinator or customer service.

Click here for informational flyer.

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We can help you find a doctor, schedule a checkup or answer any questions you have about your benefits.

Call FirstCare Customer Service at 1-800-431-7798 (STAR) or 1-877-639-2447 (CHIP). We're open 8 a.m.-5 p.m. weekdays, excluding state-approved holidays. If you call after hours, please leave us a message. We return all calls the next business day.

Our Customer Service Representatives speak both English and Spanish. If you speak another language, we can connect you with an interpreter.

Members with hearing loss can call the Relay Texas number 711. Relay Texas is a free telephone interpreting service to help people with hearing or speech disabilities.

Resources

Talk to a Nurse—Nurse24™

Need care advice? Should you see a doctor? FirstCare members can talk to a nurse by calling 1-855-828-1013. Get answers 24/7! Information is available in English and Spanish. Interpreter services available upon request. TTY users can call 711 or 1-800-955-8771. Voice communication is available at 1-800-955-8770.

Healthy Texas Women Plus

Beginning Sept. 1, 2020, Texas HHSC is implementing Healthy Texas Women Plus (HTW Plus), an enhanced, cost-effective and limited postpartum services package for women in the HTW program. HTW Plus will be provided in the postpartum period for not more than 12 months after the start date. Women in HTW Plus will have access to both HTW and HTW Plus benefits.

healthytexaswomen.org

Utilization Management

Ever wonder how we decide to authorize services? Our decisions are based on medical evidence and consensus of health care professionals.

Utilization Management Decisions

State 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 FirstCare. Members may ask for a State Fair Hearing by contacting us toll-free at 1-800-431-7798 / TTY 711. FirstCare'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 FirstCare's 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 1-800-431-7798 / TTY 711.

Grow Well™ App

Your one place to find trusted health information and connect to FirstCare resources for you and your family through every age and stage. Text “App” to 844.903.GROW (4769) or visit bfc.onelink.me

Non-Emergency Medical Transportation (NEMT)

1-833-779-3105
For more details, visit:

access2care.net/texas View more information

Prescription Benefits Manager

1-855-897-4448

Navitus Health Solutions

Behavioral Health

1-800-327-6934

Scott & White Health Plan

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