How to Get Your At-Home Covid-19 Test for free

Beginning January 3, 2022, Community First Medicaid and CHIP Members will be able to purchase over-the-counter (at-home) COVID-19 tests authorized by the U.S Food and Drug Administration (FDA) at no cost.

New Member & Provider Portal

Activation Required! Our new Member and Provider Portals have officially launched. Explore what’s new by registering for an account today.

New Member Handbooks

Find the latest member handbooks and learn more about your health plan.

COVID-19 Information

Find reliable and up-to-date information about COVID-19, including the latest news about the Delta variant, booster shots, and more.

Empowering Pathways Scholarship Program

We beleive in the strength and potential of our members of all ages, backgrounds, and diversities. Discover resources to help you on your pathway to a better future for yourself and your family.

New Value-Added Services

Review the new value-added services available to you as a Community First Health Plans Member at no-cost, including health related gift card incentives.

Fight The Flu

Learn where to get your no-cost Flu Shot and find the nearest drive-thru Flu Shot clinics.

Annual Wellness Checks

Get a checklist of questions to take with you to your next visit with your doctor.

Health Coverage For Your Child

A STEP-BY-STEP GUIDE

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 7 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

Toll-free: 1-800-434-2347
Local: (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
(210) 358-6080 or toll-free 1-800-390-1175
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

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

Providers are welcome to contact their Provider Relations Representative about health plans, Member benefits, and more.

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)

We have launched a new secure portal for both Members and Providers! You will need to create a new account to access it. Register now!

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