Wellpoint Medicaid update

If your child has a Wellpoint STAR or CHIP plan, Cook Children's will be out of network beginning Nov. 10, 2026, which means you will most likely no longer be able to continue your care with your Cook Children's care team.

• This change only affects whether Cook Children's is in your health plan's network.
• Your child's Medicaid or CHIP coverage, benefits and eligibility will not change because of this network change.
• Any services your child receives at Cook Children's before Nov. 10, 2026, are not affected.

• If your child has a medical emergency, Cook Children's will continue to provide emergency care at our emergency department regardless of insurance coverage, network status, ability to pay, or financial situation.
• Emergency care includes medical screening and treatment needed to stabilize an emergency medical condition that is provided through our emergency department.

• Care received at Cook Children's before Nov. 10, 2026, is not affected.
• Beginning Nov. 10, 2026, Cook Children's will be considered out-of-network for Wellpoint STAR and CHIP members. This means, as a Wellpoint member, you will not be able to schedule medical appointments with Cook Children’s physicians or at Cook Children’s facilities.
• Continuing to schedule medical appointments with Cook Children's physicians and at Cook Children's facilities will be possible ifyou change your child's health plan.
• Emergency care will continue to be available to all patients. 

Cook Children's continues to participate with other Medicaid managed care health plans, including Aetna Better Health and Cook Children's Health Plan in Denton, Hood, Johnson, Parker, Tarrant and Wise counties. For a complete listing, visit: Insurance Plans | Cook Children's.

Medicaid (STAR) members

STAR members can request a health plan change at any time. Plan changes can take up to 45 days to become effective.

To request a plan change:

• Call 800-964-2777
• Use the Your Texas Benefits website or app

CHIP members

CHIP members may be able to change plans based on enrollment timing, reenrollment or qualifying circumstances. Plan changes can take up to 45 days to become effective.

If you choose to stay with Wellpoint, there are some situations where Wellpoint may allow certain services at Cook Children's through a special approval process. These requests are reviewed case by case and are not automatically approved. Please contact Wellpoint to learn more about available options.

1. Access records through mychart.cookchildrens.org.
2.  Access medical records through the MyCookChildrens app. 

• On Nov. 10, 2026, Cook Children's and its facilities will be out-of-network with Wellpoint. For services on or after Nov. 10, 2026, Wellpoint will need to provide special approval for your child to be seen at Cook Children's.

• Cook Children's providers will continue to be in network with other Medicaid managed care health plans in Denton, Hood, Johnson, Parker, Tarrant and Wise counties, including Aetna Better Health and Cook Children's Health Plan.
• Families can choose whether to remain with Wellpoint or transition to another STAR or CHIP plan. Request to change your plan at: Your Texas Benefits - Learn.

• Your child's Medicaid or CHIP coverage remains intact, and Wellpoint has other in-network providers.
• Cook Children's will continue to provide emergency care services to children in our emergency department.

• Patients do not have to change their health plan.
• A patient's Medicaid or CHIP coverage remains intact, and Wellpoint has other in-network providers in the area.
• If you choose to remain with Wellpoint, we will help you transition your child's medical records to a new provider, if you would like.

• On Nov. 10, 2026, Cook Children's will be out-of-network with Wellpoint and additional approvals through Wellpoint will be required before Wellpoint members can continue receiving non-emergency care at Cook Children's.
• Some patients receiving ongoing treatment may be eligible to continue receiving care for a limited period through a “special circumstances” approval, which Wellpoint may also refer to as a continuity-of-care exception. These exceptions are for limited periods of time and depend on individual circumstances.
  • These exceptions may be available for certain patients with specific medical needs, but they are reviewed and approved by Wellpoint on a case-by-case basis and are not automatic.
  • Cook Children's cannot move forward with the patient's care until we have received a final decision on the approval or denial of those requests from Wellpoint.
  • Even with a “special circumstances” approval, each hospital-based service may require a separate prior authorization from Wellpoint for the specific service/encounter.

If you'd like to see what Medicaid options are offered in your county, please do the following:

1. Identify which county you live in from the left column.
2. Identify which current program you’re child has from the top row. (STAR, STAR Kids, STAR Plus or CHIP)
3. Those options are the health plans available for your child.

This map reflects what Medicaid options are offered in Texas, as of Sept. 2026. For more information, visit Texas Health and Human Services.