Am I Eligible

Open enrollment begins October 15, 2021, and ends December 7, 2021. Stay up to date on how to enroll, eligibility requirements, and the Special Enrollment Period when you turn 65. Effective 2019, the Medicare Advantage Open Enrollment Period (OEP) returned which allowed beneficiaries to make a change January 1st to March 31st.

Medicare D-SNP Eligibility Requirements

You can enroll in this plan if you qualify for Texas Medicaid based on standards established by the State of Texas and Federal requirements. Texas Medicaid will provide assistance with Medicare cost-sharing. Texas Medicaid also provides full Medicaid benefits. Your cost share is $0 when the service is covered by both Medicare and Texas Medicaid.

You are eligible to join the Community Health Choice (HMO D-SNP) plan if you answer “yes” to the questions below:

Questions?

Call 1.833.276.8306
(TTY users should call 711)

October 1 to March 31, 8:00 am to 8:00 pm, 7 days a week and April 1 through September 30, Monday through Friday, 8:00 am to 8:00 pm.

On certain holidays your call will be handled by our automated phone system.

Do you have Medicare Parts A and B?

You’re at least 65 years old, or you’re age 21 or older and qualify on the basis of disability or another special situation.

Do you qualify for Texas Medicaid?

21 years of age or older and qualify on the basis of disability or another special situation
65 years of age or older and receive Extra Help or assistance from the state
Eligible for Texas Medicaid (QMB and QMB+)

Do you reside within the Community Health Choice service area?

20 counties in Southeast Texas (see map)
Only individuals living in our plan’s service area are eligible to enroll in Community Health Choice’s (HMO D-SNP) plan.

Community Health Choice (HMO D-SNP)

Am I Eligible

How to Enroll

Service Area

Low Income Subsidy (LIS)

Frequently Asked Questions

Community Spotlight Blog

FInd a doctor or pharmacy

Find a Doctor or Pharmacy

Nations Hearing Benefit

Drug and Pharmacy Information

Over the Counter (OTC)

Drug List (Formulary)

Prescription Drug Transition Policy

Medication Therapy Management

Plan Material and Forms

Pre-enrollment checklist

Summary of Benefits

Evidence of Coverage

Provider Directory

How to Cancel or Leave the Plan

How to Appoint a Representative

Pharmacy Directory

Member Rights & Forms

Quality Assurance Policy

Member Rights and Responsibilities

Appeals and Grievance

Direct Member Reimbursement (DMR) Form

CMS Appointment of Representative Form

Prior Authorization Forms

Determination/Redetermination Forms

Legal Disclaimer

For Medicare Members

If your category of Medicaid eligibility changes, your eligibility for this plan will change. You will have a 6-month grace period to achieve Medicaid redetermination and will continue to be covered under this plan. During this grace period, you will be responsible for the costs of your Medicare benefits, which will be the same as if you were on Original Medicare.

Not sure if you qualify? One of our representatives can help you! Call us at toll-free at 833.276.8306 or 713.295.5007.

H9826_IT_10045_092919_M Last updated October 4, 2021.

Why Choose Community?

As a local nonprofit health plan, Community Health Choice gives you plenty of reasons to join our Community. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, Community is always working life forward for you and your family.

“I always tell people to choose Community Health Choice. I tell them it’s the best health insurance they will ever be with.”
– Chandolyn
Member of Community Health Choice