Referral Process

What is a referral? 

When your doctor thinks you need more care, you will be sent to a specialist. You may need approval from Community First. Your personal doctor will take care of the paperwork and can help you make the appointment. If you need more help, call Member Services. 

What services do not need a referral? 

Here are some services that do not need a referral: 

  • Behavioral health services 
  • Pregnancy and delivery services 
  • Glasses for Members under 21 years of age 
  • Texas Health Steps check ups from any Medicaid provider 

Family planning services from any Medicaid provider How do I get help if I have behavioral (mental) health, alcohol or drug problems? Medicaid behavioral health benefits cover: 

  • Care for mental or emotional problems 
  • Care for substance use disorder or alcohol problems 

Call the Community First Behavioral Health Hotline if you have an urgent problem like severe depression or you feel like you might harm yourself. You can call for help anytime. Behavioral Health Hotline: 1-877-221-2226 Do I need a referral for this? You do not need a referral for this. If you have a problem because of mental illness, alcohol, or drugs, please call us. You can call 24 hours a day, 7 days a week. Someone will be there to help you find professionals close to you.

Learn More About Referrals