CHIP Perinatal
CHIP Perinatal is a Texas Medicaid program that provides limited coverage during pregnancy and two postpartum visits within 60 days of the end of the pregnancy for women who can’t get Medicaid and don’t have health insurance. Community First Health Plans is the only non-profit, locally owned health plan available in our service area that offers the CHIP Perinatal program.
About CHIP Perinatal
CHIP Perinatal is designed to meet the unique needs of you and your unborn baby.
If you are pregnant, a Texas resident, you don’t have insurance, and you cannot get Medicaid, you may be able to get perinatal coverage from CHIP. This coverage is for your unborn baby. CHIP Perinatal covers labor, delivery, and your baby’s health and medical services for the first months of life.
Benefits & Services
CHIP Perinatal covers services needed to keep you and your baby healthy, including:
- Prenatal doctor visits
- Prenatal vitamins
- Labor and delivery
- Checkups and other benefits for the baby after leaving the hospital
Need a printed Member Handbook?
The CHIP Member Handbook is available to you in print, free of charge, and mailed within five business days. For your free copy, please call 1-800-434-2347 or make a request through your secure Member Portal.
Need a replacement ID card?
To replace a lost or stolen Member ID card, log in to your Member Portal. Once you have logged into your Member Portal account, use the drop-down for My Health Plan and select “ID Card Request” to order a new ID card.
Requirements
To qualify for CHIP Perinatal, you must be a Texas resident and a U.S. citizen or qualified non-citizen. If you have other health insurance, you are not eligible for the CHIP Perinatal program.
CHIP Perinatal coverage provides care to unborn children of pregnant women who are not eligible for Medicaid and who have a household income up to 202% of the federal poverty income level (FPIL). Once born, the child will receive Medicaid or CHIP benefits, depending on their income.
Eligible members include: Unborn children of pregnant women who:
- Have a household income between 199% and 202% of the FPIL.
- Have a household income at or below 202% of the FPIL, but don’t qualify for Medicaid because of immigration status.
Processes
Dedicated to the health and well-being of our Members, Community First Health Plans has developed guidelines to ensure your safety and protect your rights. Learn more about our processes and policies below.
As a Community First CHIP Perinatal Member, you have certain rights and responsibilities. You can also find your rights and responsibilities in the CHIP Member Handbook. To view the document, click here.
Community First might deny a health care service or medicine if it is not medically necessary. A medicine can also be denied if the medicine does not work better than other medicines on the Community First Preferred Drug List; or if there is another medicine that is similar that you must try first that you have not used before.
If you disagree with the denial, you can ask for an appeal.
To learn more about our appeals process, click here.
If you receive benefits through Medicaid’s CHIP Perinatal Program, contact Community First Health Plans toll-free at 1-800-434-2347 or locally at 210-358-6105 to file a complaint first. Once you have gone through our complaint process you can file a complaint to TDI. This information can also be found in your Member Handbook. To learn more about our complaint process, click here.
The Community First Health Plans Notice of Privacy Practices describes how medical information about the member may be used and disclosed and how the member can get access to this information. To learn more about our privacy policy, click here.
