If you have Medicaid in Texas, then you have the option to choose your PCP, or Primary Care Provider. Your PCP is the health-care provider you see most often, such as your family doctor. Medicaid policy in Texas does not cover office visits to a provider who is not your PCP, unless your PCP is closed at the time that you need medical care. If you are not satisfied with your PCP in Texas, you may request a PCP change up to four times a year.
Research health-care providers in your area. Texas has a searchable database of health-care providers (see Resource section) that accept Medicaid at the website of the Texas Medicaid and Healthcare Partnership. Find a provider that is close to your home or work. Make sure to call the provider and confirm that they are accepting new patients.
Call the Texas Medicaid office at 800-252-8263, and request to change your PCP. Provide the name and address of your newly chosen provider to the Medicaid office. The change may take a few days to complete, so check with your new PCP before scheduling any office visits.
Confirm that your medical records were sent to your new PCP. This is usually automatically done by your old PCP, upon Medicaid informing the PCP that they no longer may claim you as a primary Medicaid patient. Inform your new PCP of any medication that has been prescribed for you or that you are taking, including over-the-counter medicines.
Tips & Warnings
- Texas Medicaid will cover emergency medical care such as ambulatory care or Emergency Room visits, even if not provided by your PCP. Texas Medicaid policies also cover visits to specialists if referred to by your PCP.
- If you have moved to another location, update your Medicaid information by calling 800-252-8263. Current residency information is required to be updated by you for the Medicaid program.
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