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.

Community First Member Hotlines

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.

 

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.

To access the 24/7 Suicide and Crisis Line, dial 9-8-8.

 

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.

Translation Services

Community First provides free language services to people whose primary language is not English. These services include:

  • Qualified interpreters
  • Information written in other languages
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

Member Handbooks, Provider Directories, and Member Newsletters are all available in print, free of charge, and mailed to you within five business days. Member materials are also available in alternate formats such as large print, braille, or audio. To request your copy, simply call 1-800-434-2347 or make a request through the secure Member Portal.

    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

    Toll Free: 1-800-434-2347

    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

    NON-EMERGENCY MEDICAL TRANSPORTATION (NEMT)

    NEMT stands for Non-Emergency Medical Transportation. NEMT services are available to STAR and STAR Kids Members who have no other means of transportation to get to scheduled health care appointments.

    CALL MTM DIRECTLY
    1-888-444-0307
    (TTY 7-1-1)

    Call at least 2 days before you need a ride.

    Monday through Friday, from 8:00 a.m. to 5:00 p.m.
    Information is available in both English and Spanish. Interpreter services are also available.

     If you need help after hours or on the weekend, call
    Where’s My Ride: 1-888-444-0824 (TTY 711)
    24 hours a day, 7 days a week

    Service Coordination (STAR Kids)

    Service Coordination allows Community First to work together with you and your care team in order to best identify and address your needs. We will gather information and build an individual service plan (ISP) to address those needs, just for you. Service Coordination includes:

    • Assistance to ensure timely and a coordinated access to Providers and services;
    • Attention to addressing unique needs of Members; and
    • Coordination of Medicaid benefits with non-Medicaid services and supports, as necessary and appropriate.

    Contact Info

    Your Service Coordinator will provide you with a number to call them directly. If you have not been assigned a Service Coordinator or would like more information about Service Coordination, please call:

    1-855-607-7827

    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!

    MEMBER E-NEWSLETTER

    Subscribe to our Member e-Newsletter and receive news, updates, and other information designed to help you get the most out of your health plan benefits.

    If you change your mind, you can opt-out at any time.

    We can’t wait to connect with you! Thank you for choosing Community First Health Plans. We are proud to be your health plan of choice.

    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)

    ⚠❗ Attention Community First Members! The COVID-19 Public Health Emergency has ended. All Medicaid and CHIP Members must renew their coverage to keep receiving benefits.

    X
    Home
    Member Portal
    Provider Portal