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Do more for your family with RightCare's extra member benefits

Explore Extra Member Benefits

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May 23, 2024:

Due to weather-related power outages, members and providers may experience increased hold times when calling our Service Centers this morning. We expect to be back to full service capacity soon.

Chat Available Now

Log into your member portal and look for the chat icon at the bottom right of the screen.

Don't Lose Your Health Insurance

  • Review and update your contact information at YourTexasBenefits.com or call 2-1-1 and press option 2.
  • If you are no longer eligible for Medicaid, Individual and Family Marketplace options are available through Baylor Scott & White Health Plan. Due to the American Rescue Act Plan for 2021, Marketplace coverage can be as low as $0 premium.

Learn more on our site or call 866-522-2515 to speak to a licensed sales agent.

Did you get a survey in the mail?

The National Committee for Quality Assurance (NCQA) is mailing surveys to a random sample of RightCare members asking about the services we provide. If you receive a survey, please take a few minutes to respond online or by mail. Your answers are completely confidential. Thank you! Your input helps us serve you better.

Did you know you can change your primary care doctor on our member portal?

Click here for more information.

A healthcare app for the whole family!

Be informed, be engaged and be healthy with the Grow Well® app from RightCare. Learn more.

Extra Help: STAR

Check out these benefits available to qualified members.

Notice to Scott and White Health Plan RightCare Members: Emergency Medical Care

Click here for details.

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Program Overview

RightCare from Scott and White Health Plan provides STAR Medicaid services in the Medicaid Rural Service Area – Central Texas. STAR is managed care Medicaid. You pick a medical plan that provides your Medicaid services and a main doctor that is your point of contact for Medicaid services. In addition to your main doctor, each plan has a large group of specialists, therapists, clinics, and hospitals that can provide you with Medicaid services.

Texas Health and Human Service - Texas STAR

Background

Scott and White Health Plan and Insurance Company of Scott and White (SWHP) started operations in January 1982 as a nonprofit Health Maintenance Organization. Since then, our mission has been: "To provide the most personalized, comprehensive, highest quality health care, enhanced by medical education and research." SWHP was first called Centroplex Health Plan, and our service area was focused primarily in Bell and Coryell counties. Since then, we've grown our membership to more than 240,000 members and our service area to 80 counties in the Central, East, North, and West Texas regions. New insurance plans, including self-insured plans, a Medicare prescription plan, and a Medicaid plan, have been introduced to meet the needs of members, employers, and the community.

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Enjoy full Medicaid benefits with RightCare, plus so much more

Drawing upon the rich history of service and high-quality care provided throughout the Baylor Scott & White Healthcare network, RightCare offers Medicaid families in Texas everything children and pregnant moms need to be healthy. This includes all of the services covered by the Texas Medicaid program, STAR, plus these additional benefits and services.

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Our RightCare network puts you closer to the providers your family needs

Find a Provider

4,200+

Doctors & Specialists

200+

Pharmacies

40+

Hospitals & Clinics

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Availability of Materials in Alternate Formats

If you need any RightCare materials in a different format such as audio, large print, braille, or in a language other than English and Spanish; contact RightCare Member Services.

Office of Inspector General (OIG) Website Link:

Report Waste, Abuse, or Fraud to the Inspector General

Member Support

Member Services

If you have questions, call us at 1-855-TX-RIGHT. Our staff is bilingual in English and Spanish. If you speak another language or are hearing impaired, call Member Services at 1-855-TX-RIGHT (TTY 711) for help.

Regular Business Hours: Monday to Friday, 7 a.m. to 7 p.m. Central Time (except for state-approved holidays). If a medical condition is life-threatening, members should go to the emergency room. If the medical condition is non-life-threatening you can seek care at an urgent care facility or get urgent medical care from your primary care provider (PCP) within 24 hours.

If you call after hours, please leave us a message. We return all calls the next business day.

You can also visit the 24/7 Member Portal or send a Secured Message in Member Portal.

Provider Services Hotline

If you have questions, call us at 1-855-TX-RIGHT. Regular Business Hours: Monday to Friday, 8 a.m. to 5 p.m. Central Time (except for state-approved holidays). Provider can call to verify eligibility and claim inquiries.

Behavioral Health Hotline Number

If you need mental health or substance abuse services, you can call a Behavioral Health Service Coordinator at 1-855-897-4448. Behavioral Health Services are private so you do not need permission from your PCP to get these services. If you are in crisis, you can call the behavioral health crisis line at 1.844.436.8781, anytime 24 hours a day, 7 days a week, you will not get a recording. Our staff is bilingual in English and Spanish. If you need, we can arrange for an interpreter to help you. If a medical condition is life-threatening, members should go to the emergency room. If the medical condition is non-life-threatening you can seek care at an urgent care facility or get urgent medical care from your primary care provider (PCP) within 24 hours.

Need a Ride? Nonemergency Medical Transportation (NEMT)

  • Starting June 1,2021, we can help you or your child get a ride, at no cost, to the doctor, hospital, dentist, and drugstore.
  • Call us 48 hours before at 1-877-447-3101 (TTY 711) or download the Access2Care (A2C) app.
  • All you need is your ID number, provider’s name, and the address.
  • Click here to learn more.
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STAR Program Help Line (Enrollment Broker)

1-800-964-2777 (TTY: 711). Regular Business Hours: Monday to Friday, 8 a.m. to 6 p.m. CT (except state-approved holidays). The Texas STAR Program Help Line can help members change their address or phone number, or sign up their baby after birth.

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 RightCare. Members may ask for a State Fair Hearing by contacting us toll-free at 855-897-4448 (1-855-TX-RIGHT). RightCare’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 RightCare 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 1-855-897-4448.

Updated Information on EMR added to Appeals and Complaints Process page (linked off Member Homepage)

Appeals Process (linked off Member Homepage)

Subcontractor Information

RightCare uses the following subcontractors to provide members and providers the best experience:

Office of Consumer Credit Commissioner

Click here.

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Language Center

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-855-897-4448 (TTY: 711).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-855-897-4448 (TTY: 711).

View our multi-language assistance and non-discrimination notices.

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  • NCQA Health Plan Accredited
  • RightCare by Scott and White Health Plan has received Accreditation from the National Committee for Quality Assurance (NCQA). This means that RightCare by Scott and White Health Plan's service and clinical quality meet the basic requirements of NCQA's rigorous standards for consumer protection and quality improvement as well as engages in efforts to improve culturally and linguistically appropriate services and reduce health care disparities. Consumers can easily access organizations' NCQA statuses and other information on healthcare quality by visiting ncqa.org or calling NCQA Customer Support at 888-275-7585.
  • NCQA Health Equity Accredited