Eligibility and Authorization

Insurance & Medicaid Information

Coverage and network status can change. Confirm the member’s current plan and authorization before services begin.

Coverage is individual

Eligibility, covered services, authorized hours, and provider-network participation are determined by the applicable program or health plan and can change.

Have the member’s plan name available when you call. Use our before-you-call checklist to prepare your questions. Primetime will confirm current agency participation and explain what information is needed for onboarding.

No guarantee of coverage

Information on this website is general and does not guarantee eligibility, authorization, payment, or availability. Confirm benefits and network status directly with the plan and with Primetime before relying on coverage.

Insurance plans and Medicaid

Contact Primetime about services through the plans shown below. Coverage and availability depend on the member’s benefits, service authorization and location.

Call 713-977-7721 Contact Primetime

How to ask about Medicaid personal assistance

  1. Identify the plan or program. Have the plan name, client ZIP code and a short description of the daily help needed available when you call 713-977-7721.
  2. Check benefits and provider participation. Ask the plan whether personal assistance is a covered benefit for this member and whether Primetime is currently an available provider.
  3. Confirm the authorization pathway. Ask who assesses needs and issues the service authorization. For STAR+PLUS long-term services and supports, the MCO service coordinator develops the service plan with the member and coordinates authorization.
  4. Confirm agency acceptance and scheduling. If an authorization has already been issued, tell our office. Ask what documents are needed and how to provide them securely. A separate referral is not a prerequisite to an initial phone inquiry.

Do not send member numbers, medical records or authorization documents through public website messages or social media. Ask our office for the appropriate transfer method.

Which program applies?

Program requirements differ. Texas HHSC publishes separate eligibility guidance for Primary Home Care and Community Attendant Services and STAR+PLUS service coordination. These resources explain program rules; they do not confirm that a particular member qualifies or that Primetime participates in every program.

Review our non-medical attendant care scope and service-area information, then confirm your specific plan, location and approved tasks by phone.

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