Become A Member
Learn about our different health plans for your family and see if you qualify.
Become A Provider
Learn how you can join our network of partners improving the health of our community.
YOUR LOCAL, NON-PROFIT HEALTH PLAN
For over 25 years, Community First Health Plans has been providing affordable health coverage for families, children, expectant mothers, and children with special needs in Bexar county and seven surrounding counties.
Community First Member Hotlines
Nurse Advice Line
Toll-free: 1-800-434-2347
Local: (210) 227-2347
TTY: 1-800-390-1175
24 hours a day/7 days a week
Community First Health Plans has a Nurse Advice Line available to help you get the care you need, when you need it – even after hours. A Registered Nurse can provide medical advice and help you get the care you need.
For emergency services, dial 9-1-1 or go to the nearest emergency room.
Behavioral Health & Substance Misuse
STAR Kids: 1-844-541-2347
All other health plans: 1-877-221-2226
24 hours a day/7 days a week
Call toll-free to talk to someone if you need help right away. You do not need a referral for mental health or substance misuse services.
For emergency services, dial 9-1-1 or go to the nearest emergency room.
Member Services
STAR Kids: 1-855-607-7827 | (210) 358-6403
All other health plans: 1-800-434-2347 | (210) 227-2347
Monday through Friday, 8 a.m. to 5 p.m.
TTY: 1-800-390-1175
24 hours a day/7 days a week
A Member Services Representative can answer your questions about all covered services under your health care plan. Member Services can also help you select or change your
primary care provider (PCP), access services that do not require a referral from your PCP, send you a new Member ID card, and help resolve any problems or complaints.
For emergency services, dial 9-1-1 or go to the nearest emergency room.
Referrals and Prior Authorization
If you need to seek a specialty consultation or obtain a referral for specialty care and need assistance, please contact Community First Health Plans. Community First does not require a referral to see an in plan specialist. Some specialist offices require or prefer to have a “referral” from your PCP before they see you. You should ask your PCP to confirm with the specialist if a referral is needed for you to be seen. If the specialist is not a network provider, authorization for services from Community First is required to see that specialist. Community First’s Population Health Management Department will assist you, your PCP, and the specialist with the service authorization process. Community First will also try to recruit the provider to our network of physicians.
Printed Materials & Translation Services
Member Handbooks, Provider Directories, and Member Newsletters are all available in print, free of charge, and mailed to you within five business days. To request your copy, simply call 1-800-434-2347 or make a request through the secure Member Portal.
Community First provides free language services to people whose primary language is not English. These services include:
- Qualified interpreters
- Information written in other languages
STAR Medicaid
(210) 358-6060 or toll-free 1-800-434-2347
Monday through Friday, 8 a.m. to 5 p.m.
STAR Program Help Line
Call for information or to ask questions about the STAR program, benefits, or to choose a health plan.
1-800-964-2777
1-800-735-2889 (TTY)
Monday through Friday, 8 a.m. to 6 p.m.
STAR Kids
(210) 358-6403 or toll-free 1-855-607-7827
Monday through Friday, 8 a.m. to 5 p.m.
STAR Kids Behavioral Health Hotline
1-844-541-2347 or 210-358-6403
24 hours a day/7 days a week
STAR Kids Program Help Line
Call to get information or ask questions about the STAR Kids program, benefits, or to choose a health plan.
1-877-782-6440
1-800-267-5008 (TTY)
Monday through Friday, 8 a.m. to 6 p.m.
CHIP & CHIP Perinatal
(210) 358-6300 or toll-free 1-800-434-2347
Monday through Friday, 8 a.m. to 5 p.m.
CHIP Program Help Line
Call for information or to ask questions about the CHIP program, benefits, or to choose a health plan.
1-800-964-2777
1-800-735-2889 (TTY)
Monday through Friday, 8 a.m. to 6 p.m.
TTY
24 hours a day/7 days a week
Medicaid Managed Care Program Help Line
Hearing Impaired (STAR/CHIP): 1-800-735-2889
Hearing Impaired (STAR Kids): 1-800-267-5008
Community First Member Portal
The Member Portal acts as your own secure website where you can log in with your unique username and password and quickly access information about your health plan. By using the Member Portal, you can save time and take better control of your health care coverage. In just a few clicks (instead of a phone call) you can change your primary care provider, view or request a new Member ID card, check your eligibility, update your personal information, and more.
You can also access the Member Portal from any device, and toggle to view it in your preferred language!
STATE Fair Hearing & External Medical Review
If you disagree with our internal appeals decision to cover a health care service, you can ask for a State Fair Hearing.
If you ask for a State Fair Hearing, you can also ask for an External Medical Review where independent health care experts review your request to receive services.
You must make a request for a State Fair Hearing with or without an External Medical Review by 120 days from the date the notice informing you of our internal appeals decision has been mailed.
Contact Info
STAR: 1-800-434-2347
STAR Kids: 1-855-607-7827
Mailing Address:
Community First Health Plans
12238 Silicon Drive, Suite 100
San Antonio, TX 78249
Vision Services
Vision services are provided by Envolve Benefit Options through Envolve Vision. Envolve Vision works to reduce member costs while still delivering the highest quality vision benefits available.
Contact Info
Toll Free: 1-800-334-3937
Envolve Benefit Options
5130 Sunforest Drive, Tampa, FL 33634
DENTAL SERVICES
Routine dental is provided through DentaQuest, MCNA Dental, or United Healthcare
Dental. You may pick the Dental Maintenance Organization (DMO) of your choice. Call your child’s Medicaid dental plan to learn more about the dental services they offer.
Contact Info
DentaQuest: 1-800-516-0165
MCNA Dental: 1-800-494-6262
United Healthcare Dental: 1-877-901-7321
Pharmacy Benefits
Prescription drugs are a covered benefit of the Medicaid and CHIP Programs. Community First administers this benefit with the Texas Medicaid/CHIP Vendor Drug Program and our Pharmacy Benefit Manager, Navitus Health Solutions.
Contact Info
Toll Free: 1-866-333-2757
Navitus Health Solutions
361 Integrity Drive, Madison, WI 53717
Provider Hotlines
Provider Services Hotline
(210) 358-6294
(210) 358-6030 (Claims Assistance)
Monday through Friday, 8:30 a.m. to 5 p.m.
For after-hours assistance, please call 1-800-434-2347.
STAR Kids Provider Hotline
(210) 358-6403
1-855-607-7827 (toll-free)
