Your plan benefits and services in Texas

You can see your primary care provider (PCP) and specialists. Your plan also covers checkups, health screenings, prescriptions, refills, and vaccines.

Acute care needs are also covered for things like:

• flu
• sore throat
• earaches
• migraines
• fever
• minor injuries such as
  
  • strains
  • back pan
  • cuts
  • burns
  • broken bones
  • eye injuries

When your PCP is not available, you can be seen at participating urgent care centers.

Emergency care

You can go to the emergency room (ER) at any time for emergencies like:

• chest pain
• severe stomach pain
• coughing or vomiting blood
• severe burns, cuts or bleeding
• difficulty breathing or shortness of breath
• sudden dizziness, weakness or loss of balance or coordination
• numbness of the face, arm or leg,
• sudden, severe headache
• seizures
• high fevers
• any other life-threatening conditions

Your plan covers overnight hospital stays and care ordered by your doctor.

There is no cost for covered services such as PCP and specialist visits, approved drugs, hospital care, ER and urgent care, pregnancy care, mental health, labs, home health, family planning services or vaccines.