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Health Plan
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Pick your health plan from the list. If you don’t know which health plan you are in, you can:
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Look at the Your Texas Benefits Medicaid Card or health plan card.*
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Call 1-800-335-8957 (toll-free).
*Note: If you are in Managed Care please go to your health plan’s provider list or call your health plan.
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Children with Special Health Care Needs (CSHCN) Services Program:
In this program you can go to any doctor you want, as long as they are signed up with the CSHCN Services Program. You can go to a specialist without being sent by another doctor.
To learn more visit the
CSHCN Services Program website.
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Texas Medicaid Programs
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Traditional Texas Medicaid:
You can go to any doctor who takes Medicaid.
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STAR:
You pick a
Medicaid managed care health plan
and a primary care provider that is signed up with the STAR program. Your primary care provider can send you to a specialist if you need one.
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STAR+PLUS:
You pick a managed care health plan and a primary care
provider that is signed up
with the STAR+PLUS program. Your primary care provider can send you to a specialist if you need one.
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STAR Health:
Most children and young adults in state foster care or kinship care are placed in the STAR Health program.
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Medicare-Medicaid Plan (MMP):
You pick a Medicare-Medicaid health plan. When you search the Online Provider Lookup for any kind of doctor, choose provider type “Specialist.”
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Children's Medicaid Dental Services:
You choose a dental plan and a Main Dentist.
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STAR Kids:
You pick a managed care plan and a primary care provider with the STAR Kids program. Your primary care provider can send you to a specialist if you need one.
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Healthy Texas Women (HTW):
This program offers services such as woman's health exams, health screenings, and birth control.
To learn more about Medicaid plans go to the
Health and Human Services Commission’s (HHSC) website.
To search for a drug store that takes Medicaid, click on “Pharmacy Provider Search” at the bottom of the drop-down list of state health-care programs.
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Last Name/Facility Name/Group Name
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If you know the last name of the doctor or other provider, type it in. Or type in the name of the clinic, hospital or group name.
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If you don’t know the name, you don’t have to type anything in this field.
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Ordering/Referring-Only Provider
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An individual physician or other professional whose only relationship with Texas Medicaid or the CSHCN Services Program is to order or refer items or services for clients. Ordering/referring-only providers may not bill for services.
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HMO Plan Name
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You have an HMO (health maintenance organization) if you are in one of these Medicaid plans: STAR, STAR Health, or STAR+PLUS. HMOs are also known as health plan providers.
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If you don’t know which HMO you are with, you can:
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Look at the Your Texas Benefits Medicaid Card or health plan card.*
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Call 1-800-335-8957 (toll-free).
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*Note: If you are in Managed Care please go to your health plan’s provider list or call your health plan.
To learn more about Medicaid health plan providers go to the
HHSC website.
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If you know what type of doctor or provider you need, pick one of these (People in a Medicare-Medicaid health plan should always choose “Specialist”):
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Primary Care Provider:
Pick this if you are looking for a doctor, nurse, or clinic that can give you most of your health care.
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Specialist:
Pick this if you are in a Medicare-Medicaid health plan or you need a doctor that treats only a certain type of illness or a part of the body. For example, if you are looking for a doctor that treats cancer, you need to pick this.
You also should pick this if you are looking for:
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Medical equipment (things like crutches and diabetic supplies).
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Case management services for a child or pregnant woman. (This is listed in the search results as “Maternity service clinic (MSC)/Children and Pregnant Mothers (CPM) case management.”)
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Hospital/Facility:
Pick this if you are looking for a hospital or other place of care. Places of care include home health care companies, surgery hospitals, and emergency care clinics.
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THSteps Medical:
Pick this if you are looking for a Texas Health Steps medical doctor. Texas Health Steps is a program for children from birth to age 20. Texas Health Steps doctors can give checkups, vaccines, vision and hearing screenings, health education, and much more.
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THSteps Dental:
Pick this if you are looking for a Texas Health Steps dentist. Texas Health Steps is a program for children from birth to age 20. Texas Health Steps dentist can give dental checkups, treatment, and emergency dental care.
You also should pick this if you are looking for a dentist who treats people who: (1) are age 21 and older, and (2) live in a care facility for people with mental disabilities (ICF-MR).
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Mental Health Services:
Pick this if you are looking for a doctor or place that can treat mental health or substance abuse issues.
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Vision:
Pick this if you are looking for a doctor or place that can give eye and vision care.
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The option you pick in this list affects what shows up in the Step 4 - Provider Specialty list.
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To learn more about providers and Medicaid services, refer to your Medicaid guide. Links to Medicaid guides can be found on the
HHSC website.
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Urgent Care Center
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An urgent care center is a place that is open late to care for non-life-threatening illnesses and injuries. It is not a hospital or emergency room. Patients do not need an appointment.
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You must enter either a ZIP code or county. You can’t enter both.
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Zip Code
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Enter the 5-digit ZIP code close to where you want to find a doctor.
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Distance from ZIP Code
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This drop-down list will only open if you entered a 5-digit number in the ZIP Code box.
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Use this drop-down list to pick how many miles away you want to search from the ZIP code you entered.
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If you don’t pick the number of miles, the search will include only the ZIP code you entered.
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Provider County
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This drop-down list will open only if the ZIP Code box is empty.
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Use this drop-down list to pick the counties where you want to find a doctor.
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You can pick up to 5 counties. To pick more than 1 county, hold the Control (Ctrl) key down while clicking the county names you want.
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Step 4 is only on the “Advanced Search” page. The link to get to the “Advanced Search” page is at the top of the “Basic Search” page.
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Accepting New Patients
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Pick one of these from the drop-down list:
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Current patients only:
Pick this to find doctors and other providers that are only taking patients they have seen before.
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Not accepting new patients:
Pick this to find doctors and other providers that are not taking any patients.
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Accepting new patients:
Pick this to find doctors and other providers that are taking new patients.
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Provider Specialty
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This drop-down list will open only if you pick an option in Step 2 – Provider Type.
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You can pick a doctor or other provider that treats only certain types of illness or parts of the body (called a specialty).
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If you don’t find the type of doctor you want, try a new search using “Provider Subspecialty” or “Other Services Offered.”
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Provider Subspecialty
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This option is for people looking for a doctor or provider that is more specialized. For example, you can search for a provider that has done bone marrow transplants.
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You can only select a subspecialty if you have already selected a provider type and provider specialty.
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Other Office Hours
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You can use this if you are looking for a doctor who sees patients outside normal hours.
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Extended:
Pick this if you are looking for a doctor who can see you before 8 a.m. or after 5 p.m.
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Weekend:
Pick this if you are looking for a doctor who can see you Saturdays or Sundays.
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No Preference:
Pick this if the doctor’s work hours don’t matter to you.
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Special Services
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Chemical Dependency Treatment Facility (CDTF):
Helps find services for people with substance abuse
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Children Unit(s):
Pick this if you would like a hospital with a designated children's unit(s). This is different from a Children's Hospital.
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First Dental Home (Dental for Children Under 3):
Pick this if you need a dentist for a child age 6 months to 3 years.
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Hearing Aid Fitting and Dispensing:
Pick this if you would like a provider who fits and dispenses hearing aids. Not all Audiologists and Otorhinolaryngologists (ENTs) provide these services.
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Hearing Services for Children and Young Adults (ages 20 or younger):
Pick this if you need to get a hearing test or hearing aids for a child age 20 or younger.
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High risk obstetrics:
Pick this if:
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You are pregnant.
And
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You have health issues that might affect you or the unborn baby.
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HIV care:
Pick this if you need care related to the Human Immunodeficiency Virus (HIV).
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Oral Evaluation—Medical Home:
Pick this if you would like a medical doctor who can check your child’s teeth. This doctor might also be able to give a fluoride treatment. In some cases, this doctor would need to be your child’s primary care provider – your child’s main doctor. This doctor would refer your child to a dentist for their dental checkups.
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Telemonitoring:
Home telemonitoring is a health service that requires scheduled remote monitoring of data related to a client’s health, and transmission of the data to a licensed home health agency or a hospital.
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Opioid Treatment Providers:
Pick this if you are looking for opioid treatment services.
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If you don’t find the type of doctor you want, try a new search using “Provider Specialty” or “Provider Subspecialty.”
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Other Language Spoken
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Use this field to find a doctor that speaks a language other than English. If you want a doctor who speaks English, keep the list on “Select Language.”
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Patient Age
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Pick the age of the person that needs a doctor from the drop-down list. Some doctors treat people only if they are in a certain age group.
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Gender Served
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Pick the gender (male or female) of the person that needs a doctor. Some doctors treat only males or only females.
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County Served
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You can pick a county where you want to find a doctor or other provider.
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Search (button)
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When you have finished picking options for your provider search, click this button.
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Clear form (button)
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If you want to start your search over, click on this button. It will clear the form.
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You will see a list of providers that match all of your search details.
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Sorting the list
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You can sort the list by provider name, specialty, or distance. Click on “Sort Results by” at the top of the page.
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Pick the view you want from the drop-down list:
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Location Distance:
This sorts the list so the doctor or provider closest to you is at the top (see 4th column).
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Weekend:
This sorts the doctor or provider names alphabetically – A to Z (see 1st column).
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No Preference:
This sorts the doctor or provider specialties alphabetically – A to Z (see 2nd column).
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See the address on a map
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You can see the address on a map by clicking “View Map.” This is in the “Distance” column.
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Learn more about the doctor or provider
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You can find out more about a doctor or provider by clicking on their name. A new page will open. Information you will see includes their address, phone number, their gender (male or female), what HMOs they work with, and more.
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Participating Plans – Service Area
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This area shows the HMOs the doctor or provider works with.
The HMOs that allow that doctor or provider to be a
primary care provider
have a green check mark next to their name (
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Example:
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Participating Plans - Service Area
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Accepting New Patients
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SUPERIOR HEALTH PLANS - TRAVIS
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Yes
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AMERIGROUP, TEXAS, INC. - TRAVIS
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Yes
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AMERIGROUP COMMUNITY CARE - TRAVIS
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Call Provider
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TRADITIONAL MEDICAID
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Call Provider
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For example, if the doctor has this chart on his or her page, this means:
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The doctor works with all the HMOs listed above and traditional Medicaid.
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The only HMO that allows this doctor to be a primary care provider is “Amerigroup, Texas, Inc. – Travis.”
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Note: “Traditional Medicaid” will never have a green check mark next to it. People who get traditional Medicaid don’t have a primary care provider.
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No Results Found
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If no doctor or provider matches all of your search details, you will get this message: “No results found.”
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Click on the “Change Search Details” button to make changes to your search. You might need to pick fewer details in your search.
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If you still can’t find a doctor or provider, call us at 1-800-335-8957 (toll-free).
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