Community First Health Plans provides healthcare for children and youth who receive disability-related Medicaid in the Bexar service delivery area. The program is the first Medicaid managed care program specifically for people who are 20 and younger, have a disability, and use Medicaid.
Program Benefits & Services
STAR Kids is designed to meet the unique needs of children and youth with disabilities. The program will include access to benefits such as:
- Prescription drugs
- Hospital care
- Primary and specialty care
- Preventive care
- Personal care services
- Private duty nursing
- Durable medical equipment and supplies
- MDCP services
- Medically Dependent Children Program (MDCP)
- Home and Community-based services (HCS)
- Community Living Assistance and Support Services (CLASS)
- Deaf Blind with Multiple Disabilities (DBMD)
- Texas Home Living (TxHmL)
- Youth Empowerment Services (YES)
Texas Health Steps
The Texas Medicaid Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program is a federally mandated health care program of prevention, diagnosis, and treatment for Medicaid recipients from birth through 20 years of age. In Texas, the EPSDT program is known as Texas Health Steps. Texas Health Steps is administered by Texas Health & Humans Services Commission (HHSC).
Texas Health Steps medical providers must perform medical checkups on any client who is currently enrolled in Medicaid, birth through age 20. Providers also are encouraged to notify the client when he or she is due for the next medical checkup according to the Texas Health Steps Periodicity Schedule.
Note: Newly enrolled STAR Kids Members must receive a Texas Health Steps medical checkup within 60 days from enrollment.
Free online provider education is available from both Community First Health Plans and Texas Health and Human Services Commission (HHSC). Many include Continuing Education credits. Check out the online options offered by HHSC and see below for Community First-led training sessions for our Providers.
For additional information about the STAR Kids Program, visit Texas Health & Human Services Commission (HHSC)
Community First Provider Educational Webinars
Access our library of benefits and resources available to our members from our Resources.
Handbooks, manuals, and Community First Health Plans’ newsletters are available in print, free of charge, and mailed within 5 days by calling Provider Relations at 210-358-6294 or by making a request through the secure Provider Portal.
Referrals & Letters of Agreement
Community First Health Plans does not require a referral for a Member to see a specialist. Some specialist offices may require or prefer to have a “referral.” PCPs should confirm with the specialist if a referral is needed from the PCP’s office for a patient to be seen.
If the specialist is out-of-network, Community First Health Plans will work to complete a Letter of Agreement (LOA)/ Single Case Agreement with the non-network specialist. These LOA/Single Case Agreements can be for one or several visits and lengths of time, depending on the medical necessity as determined by Community First Health Plans.
Maintenance & Outages
Any downtime for routine scheduled maintenance for Provider-facing systems are posted to Community First Health Plans’ website and shared with Community First Health Plans staff. A toll-free number is also provided and shared.
For outages and/or unplanned downtime, information will be posted to Community First Health Plans’ website, and appropriate toll-free numbers will be posted and shared with Community First Health Plans’ staff.
If you are a Community First Provider and need to reach us after hours or on the weekend, please call 210-227-2347.