Provider Finder® of BCBSIL

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Please choose a PCP from the provider network when you join. If your child sees and out-of-network PCP or a PCP from a non-Medicaid plan, we can help you stay with that PCP. You should let us know If you would like your child's specialist to be their PCP.
If your child has both Medicare and Medicaid coverage, you have two kinds of medical coverage. Your STAR Kids benefits will not reduce or change any of your Medicare benefits. Your child?s PCP will be the doctor you have chosen through the Medicare plan. You do not have to choose another PCP for STAR Kids services. Make sure that your Service Coordinator knows the name of your Medicare PCP.
All members, please call Service Coordination so we can get information on PCP that you want to use, and we will help get the appropriate PCP assigned. After you choose a PCP, you will then get a new ID card that shows "Commercial PCP" or "Dual Eligible" for members that have Medicare. You can call customer service at 1-877-688-1811 (TTY 7-1-1) for help choosing an in-network PCP.

You do not need referrals to see in-network specialists. BCBSTX allows you to see out-of-network Medicaid specialists for medically necessary services. If you think you need to see an out-of-network specialist, contact your PCP first.
OB/GYN Providers
BCBSTX also allows you to see out-of-network OB/GYN providers for medically necessary services. You should notify a Service Coordinator if you are going to see an out of network OB/GYN to ensure that the provider is loaded in our system so that they can file claims.
Behavioral Health and Substance Abuse Treatment Services
You do not need a referral for behavioral health or substance abuse treatment services to see a Magellan network provider. BCBSTX STAR Kids members get behavioral health/substance abuse services through Magellan Health Services.
If you want to see an out-of-network provider, you need to get a prior authorization for to ensure Magellan has the provider information needed to accurately pay claims. A Magellan Health Care Coordinator will work with your child's service coordinator to ensure your child has access to the behavioral health services needed. You can also call Magellan at1-800-424-0324.

Provider Finder®