Members

 

MEMBER HANDBOOKS

 

PROVIDER DIRECTORY

Cigna-HealthSpring works with many Primary Care Providers (PCP), specialists and hospitals to meet your health care needs. With this tool, you can find health care providers in your area.


  • How do I pick my main doctor?
    When you join Cigna‑HealthSpring, you need to pick your main doctor from the Provider Directory. If you need help picking a main doctor, please call Member Services toll-free at 1‑877‑653‑0327 (TTY 711).
    Learn More about Primary Care Providers

  • What is a referral?
    A referral may be needed from your main doctor to get some services. Your main doctor must provide routine specialty care referrals on a timely basis based on the urgency of your medical condition but no later than 30 days after request if a referral is required. Always ask your main doctor if you need a referral to get the services you need.

  • What services do not need a referral?
    You should always call your main doctor to find out if the services you need require a referral. You don’t need a referral for:
    • Behavioral health
    • OB/GYN
    • Family planning
    Learn More about Referrals

 

 

DRUG STORE INFORMATION

 

 

BEHAVIORAL HEALTH RESOURCES

 

 

HEALTH INFORMATION

 

 

QUALITY & HIPAA

Read about how medical information about you may be used and disclosed and how you can get access to this information.

 

 

APPEALS & COMPLAINTS

 

 

ADDITIONAL MEMBER RESOURCES

 

 

HELPFUL MEMBER INFORMATION


  • Lost or Stolen ID Card?
    If you lose your Member ID Card, please call Member Services at 1-877-653-0327 (TTY 711), Monday to Friday from 8 a.m. to 5 p.m. Central Time. We will send you a replacement card.

  • Member Rights and Responsibilities
    You have the right to respect, dignity, privacy, confidentiality, and nondiscrimination.
    Learn more about your Member Rights and Responsibilities: Visit Member Rights and Responsibilities | View Member Handbook

  • Texas Health Steps
    Texas Health Steps offers regular medical, dental, and vision checkups. It also offers vaccines to infants, children, teens, and young adults aged 0‑20. For more information call Cigna‑HealthSpring at 1‑877‑653‑0327 (TTY 711) or Texas Health Steps 1‑877‑847‑8377 (1‑877‑THSTEPS) (toll‑free), Monday to Friday, 8 a.m. to 8 p.m.
    Learn more about Texas Health Steps: Visit Texas Health Steps | View Member Handbook

  • Notice of Privacy Practice
    Learn more about our Notice of Privacy Practice

  • Member Advisory Group
    Cigna–HealthSpring STAR+PLUS would like to have you join our Member Advisory Group. We meet quarterly with our members to learn what they like about their Cigna-HealthSpring health plan and how we can make the health plan even better. We review our value-added benefits and answer any questions about Service Coordination and how to reach your Service Coordinator or Member Advocate! And we often bring in speakers who talk about ways to have a healthier lifestyle.

    If you want to join our Member Advisory Group meeting or attend other member events, please call toll-free at 866-913-0943 (TTY 711) and leave your name and a telephone number where we can reach you. Or you can email us at: TXMemberAdvocates@healthspring.com. Our Member Advocate will get back with you to tell you about our next Member Advisory Group meeting!

  • Medicaid Appeals Process
    You or your authorized representative can file an appeal with Cigna‑HealthSpring.
    How to File an Appeal: English | En Español
    Learn More about the Appeals Process: Visit Appeals & Complaints | View Member Handbook

  • Fair Hearing Process
    You or your authorized representative can ask for a State Fair Hearing at any time during the Appeals process or after the decision on your Appeal.
    Learn More about the Fair Hearing Process: Visit Appeals & Complaints | View Member Handbook

  • Medicaid Complaint Process
    If you have a complaint, please call us toll‑free at 1‑877‑653‑0327 (TTY 711) to tell us about your problem.

    If you receive benefits through Medicaid’s STAR, STAR+PLUS, STAR Health, or STAR Kids program, call your medical or dental plan first. If you don’t get the help you need there, you should do one of the following:

         a. Call Medicaid Managed Care Helpline at 1-866-566-8989 (toll-free).

         b. Online: Online Submission Form (only works in Internet Explorer)

         c. Mail: Texas Health and Human Services Commission

                      Office of the Ombudsman, MC H-700
                      P.O. Box 13247
                      Austin, TX 78711-3247

         d. Fax: 1-888-780-8099 (toll-free)

    Learn more about the Complaint Process: Visit Appeals & Complaints | View Member Handbook

 

 

STATE NOTIFICATIONS

There are no notifications available at this time.