If your child needs care for mental health or substance use, Blue Cross and Blue Shield of Texas (BCBSTX) partners with Magellan Health Services to offer care for children and youth in the BCBSTX STAR Kids Plan.
Behavioral health care does not need approval from your child's primary care physician (PCP). Prior authorization is not needed for outpatient care. Your behavioral health service coordinator will work with you to find the provider you want to see. You do not need authorizations for in-network behavioral health providers for medically necessary services. If the provider is out of network, work with your service coordinator to make arrangements for your out-of-network provider to care for your child and get paid appropriately. Magellan will also attempt to get the provider into Magellan's network.
Magellan's care managers work together with your child's doctors to create care plans. The Magellan program offers:
- Help getting services. A licensed Magellan care manager can help arrange services for your child. This could be mental health care, or alcohol or drug use treatment.
- Care management. Your child may be getting care at a hospital, at another type of treatment facility or from a provider. If so, Magellan's clinical staff will stay in contact with them to keep track of your child's progress.
- Service coordination. Magellan care managers will work alongside your personal service coordinator to help identify needs. They can also connect you to services and qualified providers.
- Community services. Magellan's staff can help find services for your child in the community to help them succeed at home and in school. Community services may include skill-building programs and parent/family support groups.
As part of the STAR Kids Plan, Magellan offers mental health rehabilitation services. These include:
- Skills Training
These services help your child's mental health improve over time. Also, a youth may have alcohol and/or drug problems. If so, they can get substance use rehabilitation services. This includes counseling and treatment.
Emergency and Crisis Support
In addition, Magellan offers emergency and crisis support. If, at any time, your child is acting in a way that you think might lead to a mental health emergency situation, call Magellan. You may call at any time of day or night, and on any day of the week. You will be able to talk to a mental health professional.
Applied Behavioral Analysis for Children with Autism Spectrum Disorder
Applied Behavioral Analysis (ABA) therapy is now a benefit for STAR Kids members as a covered benefit through Texas Medicaid. ABA can help children with Autism Spectrum Disorder (ASD) develop improved function with their peers and caregivers. To qualify for ABA, your child must first have special testing to confirm their diagnosis of ASD.
ABA testing is more thorough than what most pediatricians can do as part of their practice. The testing must be performed by a specialist such as a developmental pediatrician, a neurologist, a psychiatrist, a licensed psychologist, or an Autism diagnosis team. Speak to your child’s pediatrician about getting a referral to one of these specialists.
Please see the ABA therapy Frequently Asked Questions for more information.
Go to Provider Finder® to search for and print a list of ABA providers in your area.
If you have more questions about ABA services, please call BCBSTX STAR Kids Service Coordination toll-free at 1-877-301-4394. Members with hearing or speech loss can call the TTY line at 711.