Frequently Asked Questions

Below are some frequently asked questions. If you have any other questions or need help, please contact Cigna-HealthSpring Member Services at 1-877-653-0327.


  1. How do I change my PCP (primary care provider)? How long will it take to make the change?

    If you would like to change your PCP, you may call Cigna-HealthSpring Member Services at 1-877-653-0327. Please inform the Member Services Representative that you would like to change your PCP. They will also assist you with finding a PCP if you do not already have one.


    If you request to change your PCP, the change will take place on the next business day after the request. A new Cigna-HealthSpring ID card will be mailed to you within 5 business days of the request. The actual delivery time is based on the US Postal Service.


  2. What are Cigna-HealthSpring Service Coordinators? What do they do for me?

    Service coordination is a service Cigna-HealthSpring provides for you. You and your Cigna-HealthSpring Service Coordinator work together to assess your health needs. Together you will also create a care plan, coordinate all your services and then monitor your progress toward your health care goals.


    When you talk or meet with your Cigna-HealthSpring Service Coordinator, you will be given the Service Coordination phone number. You will be able to contact your Cigna-HealthSpring Service Coordinator by phone at 1-877-562-4402 with questions and concerns. You can also call Cigna-HealthSpring's Member Services at 1-877-653-0327 to contact your Service Coordinator.


    The Cigna-HealthSpring Service Coordinator’s job is to help you coordinate all of the services needed to meet your health care needs. Your Service Coordinator will:

    • Call you and get to know you and your health care, long-term care and behavioral health needs

    • Use a health risk assessment to help decide if you need more help right away

    • Talk with any case managers, doctors, pharmacists or other persons that you say are important for your care needs

    • Help you find the services you need in your community

    • Write a care plan with you, your family's and your PCP’s help

    • Stay in contact with you to check up on your health and keep track of your care plan and the progress you are making toward your care plan goals


  3. What are Long–Term Services and Support (LTSS) Benefits?

    The following is a list of Long–Term Care and Home and Community Based Services for which you may be eligible:

    • Adaptive aids such as: wheelchairs, walkers, canes, and durable medical equipment

    • Adult Foster Care

    • Assisted Living Services

    • Consumer Directed Services

    • Day Activity and Health Services

    • Dental Services

    • Emergency Response Services

    • Home Delivered Meals

    • Minor Home Modifications

    • Nursing Facility Services

    • Personal Care Attendant

    • Respite Care Services

    • Therapy Services

    • Transition Assistance Services


    For more information call your Service Coordinator at 1-877-562-4402 or Cigna-HealthSpring Member Services at 1-877-653-0327.


  4. How do I call for a ride to a medical appointment?

    If you do not have a car or cannot get a ride for a medical visit, you can call the Medical Transportation Program for a ride at 1-877-633-8747. This program will help you get to a doctor’s visit for the care you need. This program is not for emergency transportation. If you have an emergency and cannot get a ride, call 911.


    Call the Medical Transportation Program at 1-877-633-8747. Tell them why you need a ride, if you need help during the ride, (like a wheelchair), and give them all of your Medicaid information. If you need help with setting up a ride, call Member Services. They will make the call with you.


    You should call for a ride as soon as you make your medical appointment. For routine medical care, you need to call at least two (2) days before your visit. If you have a visit outside of the county you live in, you will need to call at least five days before your visit. The sooner you call, the better.


  5. What Substance Abuse Services are available?

    The following outpatient substance abuse services are available :

    • Outpatient mental health services for children and adults

    • Detoxification services
    • Psychiatry services

    • Counseling services

    • Assessment by a provider or a self-referral

    • Substance use disorder treatment in residential and non-residential settings

    • Medication-assisted therapy


    The following inpatient services are available:

    • Inpatient mental health services for children and adults

    • Substance use disorder treatment in residential settings

    • Detoxification services


  6. How do I get behavioral health services?

    Behavioral health refers to the care and treatment of mental health issues or people with an addiction to drugs or alcohol.

    If you have a life threatening emergency or an emergency that poses a threat to the lives of others or property, call 911 or go directly to the nearest emergency room.

    If you have a mental health crisis, you can get help by calling the Cigna-HealthSpring Crisis Hotline at: 1-877-562-4397.


    You can get help by calling the Cigna-HealthSpring Member Services at 1-877-653-0327.

    Qualified mental health professionals will be available 24 hours per day, 7 days per week to answer your questions, assess your mental health, and provide and coordinate services as needed.


  7. What do I do in case of an emergency?

    If you have a life threatening emergency or an emergency that poses a threat to the lives of others or property, call 911 or go directly to the nearest emergency room.


  8. What is a specialist?

    A specialist is a doctor who treats specific health problems, like a heart doctor, a skin doctor, or a bone doctor. Your PCP can help you decide when you need to see a specialist.

    You can see a Cigna-HealthSpring OB/GYN, an eye doctor, a dentist, a mental health doctor, or go to family planning services without talking to your PCP.


  9. Can I call the Nurse Line at any time? What kinds of things can the nurses help me with?

    Cigna HealthSpring gives you access to experienced registered nurses 24 hours a day, 365 days a year. Our nurses offer immediate, reliable information for any health concern. Please call 1-855-418-4552. Help is ready in English or Spanish.


  10. What do I need to bring with me to my doctor’s appointment?

    • Your Cigna-HealthSpring I.D. Card

      and

    • Your Texas Benefit Medicaid Card

      or

    • Temporary Medicaid ID form- Form 1027-A

     


  11. What if I want to change health plans?

    If you are not in the hospital, you can change your health plan by calling the Texas STAR or STAR+PLUS Program Helpline at 1-800-964-2777. You can change health plans as many times as you want, but not more than once a month. If you are in the hospital, you will not be able to change health plans until you have been discharged.


    If you call to change your health plan on or before the 15th of the month, the change will take place on the first day of the next month. If you call after the 15th of the month, the change will take place the first day of the second month after that. For example:


    • If you call on or before April 15, your change will take place on May 1.

    • If you call after April 15, your change will take place on June 1.


  12. Who do I call for an interpreter?

    Your doctors must provide help to you if you have limited English speaking or reading skills.

    If your doctor is unable to get an interpreter for you, they may contact Cigna-HealthSpring for help by calling the Provider Hotline at 1-877-653-0331.


    You will need to check with your doctor’s office to confirm their procedures for getting interpreter services. However, if they are using the help of the Cigna-HealthSpring vendor Language Line Services, no advance notice is required but is only available Monday to Friday, 8 a.m. to 5 p.m. Central Time.


  13. How do I get family planning services?

    Family planning services such as birth control and counseling are very private; you do not need to ask your PCP to get these services. You can go to any family planning provider who takes Medicaid.


    You do not need to ask your PCP to get these services.


  14. What if I also have Medicare?

    If you have Medicare coverage in addition to STAR+PLUS, your Medicare coverage will be your primary coverage. This means that your Medicare coverage is always the first insurance to be used. STAR+PLUS will not change your Medicare coverage.


  15. What happens if I lose my Medicaid coverage?

    If you lose Medicaid coverage but get it back again within six (6) months you will get your Medicaid services from the same health plan you had before losing your Medicaid coverage. You will also have the same Primary Care Provider you had before.


  16. How do I file a complaint?

    If you or an authorized representative wishes to file an Appeal or Complaint you may call Cigna-HealthSpring Member Services at 1-877-653-0327, Monday to Friday, 8 a.m. to 5 p.m. Central Time, excluding state-approved holidays. If the call is after hours, please leave a message and your call will be returned within 1 business day.


    For all services other than Prescription Drugs/Pharmacy you can fax your Expedited Appeal to 1-877-809-0783 or mail your request to:

    Cigna-HealthSpring
    Attention: Appeals and Complaints Department
    P.O. Box 211088
    Bedford, TX. 76095

    For all Pharmacy (STAR+PLUS Expedited Appeals) you can fax your Expedited Appeal to 1-866-766-6405. Or you can write us and send your request to:

    Cigna-HealthSpring
    Attention: STAR+PLUS Appeals
    PO Box 24207
    Nashville, TN 37202



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