Thinking about becoming a Community Health Choice Member? Here are some quick facts about the CHIP Program and Community Health Choice to get you started.
CHIP and Medicaid automatic benefit renewal has ended.
Visit our public health emergency site for more information.
CHIP is a health insurance plan for children under the age of 19. It is for families who earn too much money to qualify for Texas Medicaid programs and cannot afford to buy private insurance.
Community Health Choice is a managed care organization that offers Texas CHIP coverage and provides services that are covered benefits of the CHIP Program. Read the Benefits section of our Member handbook and our Evidences of Coverage to see what is covered, what is not covered, and how to get these benefits.
The Community Health Choice Network covers 20 counties in southeast Texas. Participating practitioners and providers are inside our service area.
If you/your child needs medical care when traveling, call us toll-free at 1.888.760.2600, and we will help you find a doctor. If you/your child needs emergency services while traveling, go to a nearby hospital and then call us toll-free at 1.888.760.2600. If you/your child needs medical care when out of state, call us at 713.295.2294 or toll-free at 1.888.760.2600, and we will help you find a doctor.
If you/your child needs emergency services when out of state, go to a nearby hospital, then call us at 713.295.2294 or toll-free at 1.888.760.2600. You/your child will need to return to our service area for follow-up care when well enough. We cover care for true emergencies anywhere you/your child go inside the United States. You do not need to call your/your child’s Perinatal Provider or Primary Care Provider before getting emergency care but do call your/your child’s Perinatal Provider or Primary Care Provider and our Member Services within 24 hours of the emergency or as soon as possible.
Medical services performed out of the country are not covered by CHIP.
Read about our service area coverage in our CHIP Handbook.
Read our benefits and exclusions in our CHIP and CHIP Newborn Evidence of Coverage booklets.
After a person chooses a managed care organization, like Community Health Choice, to provide their health care, they then choose a Primary Care Provider to give them all their primary care services. This includes coordinating referrals for all medically necessary specialty services. Want to see if your Provider, specialist or hospital is in our network? Search our Find a Doctor directory. |
Community follows the Texas Vendor Drug Formulary for Medicaid and CHIP. Updates to the formulary are managed by the Texas Vendor Drug Program.
Here is how to search:
This search will tell you:
Drugs are listed as “preferred” and “non-preferred.” If you need a “non-preferred” drug, your doctor will need to submit a special request to get the “non-preferred” drug by calling Member Services toll-free at 1.888.760.2600.
Our Notice of Privacy Practices is given to you as part of the Health Insurance Portability and Accountability Act (HIPAA). It says how we can use or share your protected health information (PHI) and sensitive personal information (SPI). We review this notice annually and update if needed.
“Protected health information” and “sensitive personal information” (PHI/SPI) is information that identifies a person or patient. This data can be your age, address, e-mail address, and medical facts. It can be about your past, present or future physical or mental health conditions. It also can be about sensitive healthcare services and other personal facts.
It tells you who we can share it with and how we keep it safe. This includes protection of your oral, written and electronic information across the organization. It tells you how to get a copy of or edit your information. It ensures that any oral, written, and electronic information you share with us is confidential and secure.
You can allow or not allow us to share specific details unless needed by law. You have the right to approve or withdraw the use of your information.
Read our full Privacy Notice section in our Member Handbook.
Have you lost your Medicaid benefits? The Healthy Texas Women Program provides family planning exams, related health screenings, and birth control to women ages 18 to 44 whose household income is at or below the program’s income limits (185 percent of the federal poverty level).
You must submit an application to find out if you can get services through this program. Visit the Healthy Texas Women website for more information.
CHIP Member Services
Local: 713.295.2294 | Toll-Free: 1.888.760.2600
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 6:00 p.m
General Information
Local: 713.295.2222 | Toll-Free: 1.877.635.6736
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 6:00 p.m.
Providers Hotline
Local: 713.295.2295
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 5:00 p.m
CHIP is a health insurance plan for children under the age of 19. It is for families who earn too much money to qualify for Texas Medicaid programs and cannot afford to buy private insurance.
Community Health Choice is a managed care organization that offers Texas CHIP coverage and provides services that are covered benefits of the CHIP Program. Read the Benefits section of our Member handbook and our Evidences of Coverage to see what is covered, what is not covered, and how to get these benefits.
The Community Health Choice Network covers 20 counties in southeast Texas. Participating practitioners and providers are inside our service area.
If you/your child needs medical care when traveling, call us toll-free at 1.888.760.2600, and we will help you find a doctor. If you/your child needs emergency services while traveling, go to a nearby hospital and then call us toll-free at 1.888.760.2600. If you/your child needs medical care when out of state, call us at 713.295.2294 or toll-free at 1.888.760.2600, and we will help you find a doctor.
If you/your child needs emergency services when out of state, go to a nearby hospital, then call us at 713.295.2294 or toll-free at 1.888.760.2600. You/your child will need to return to our service area for follow-up care when well enough. We cover care for true emergencies anywhere you/your child go inside the United States. You do not need to call your/your child’s Perinatal Provider or Primary Care Provider before getting emergency care but do call your/your child’s Perinatal Provider or Primary Care Provider and our Member Services within 24 hours of the emergency or as soon as possible.
Medical services performed out of the country are not covered by CHIP.
Read about our service area coverage in our CHIP Handbook.
Read our benefits and exclusions in our CHIP and CHIP Newborn Evidence of Coverage booklets.
After a person chooses a managed care organization, like Community Health Choice, to provide their health care, they then choose a Primary Care Provider to give them all their primary care services. This includes coordinating referrals for all medically necessary specialty services. Want to see if your Provider, specialist or hospital is in our network? Search our Find a Doctor directory. |
Community follows the state Vendor Drug Formulary for Medicaid and CHIP. You can review the list at https://www.txvendordrug.com/
formulary/formulary-search
This list will tell you:
If the drug you need is non-preferred, you will need to request an exception by contacting Member Services toll-free at 1.888.760.2600.
“Protected health information” and “sensitive personal information” (PHI/SPI) is information that identifies a person or patient. This data can be your age, address, e-mail address, and medical facts. It can be about your past, present or future physical or mental health conditions. It also can be about sensitive healthcare services and other personal facts.
Read the Privacy Notice section in our Member Handbook for more information.
Have you lost your Medicaid benefits? The Healthy Texas Women Program provides family planning exams, related health screenings, and birth control to women ages 18 to 44 whose household income is at or below the program’s income limits (185 percent of the federal poverty level).
You must submit an application to find out if you can get services through this program. Visit the Healthy Texas Women website for more information.
CHIP Member Services
Local: 713.295.2294 | Toll-Free: 1.888.760.2600
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 6:00 p.m
General Information
Local: 713.295.2222 | Toll-Free: 1.877.635.6736
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 6:00 p.m.
Providers Hotline
Local: 713.295.2295
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 5:00 p.m
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.
“Community Health Choice is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.”
– Cecily
Member of Community Health Choice
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