Annual Notices

Information that must be available on an annual basis. Check back here for updates to STAR (Medicaid) coverage updates.

Apply for Texas STAR (Medicaid)

Important Things to Remember

We are here to help you get the most from your health coverage. Here are some important things to remember:

Read your handbook. If you have any questions, call Member Services toll-free at 1.888.760.2600.
Read your Rights and Responsibilities as a plan Member in your handbook.
Find a Primary Care Provider on our online Provider Directory. If you need help finding a provider, call Member Services toll-free at 1.888.760.2600. When you pick your Provider, you must call us so we can assign that Provider to you. You can also create an online account at CommunityHealthChoice.org > Member Login and choose your Primary Care Provider.
You will receive your Community Health Choice Member ID card within 5-7 business days after you have told us who you chose to be your Primary Care Provider. Review your information on the card. If there are any errors, contact us immediately.
Call your Primary Care Provider listed on your Member ID card to schedule your first Texas Health Steps checkup:
- As a new Member, you should have your first Texas Health Steps checkup within 90 calendar days after joining Community Health Choice.
- Newborns should be seen by a Primary Care Provider 3-5 days after birth.
Show your Community Health Choice Member ID card every time you go to the doctor’s office, clinic, hospital or drug store to get your prescription filled.
If you have special health care needs, we can help! We can enroll you into one of our Care Management Programs or refer you to the Case Management for Children and Pregnant Women Program.
If you are a Member of a migrant farmworker family, we can help you get all the health care services you need before you travel.
Always carry your Community Health Choice Member ID card with you.

As a Member of Community Health Choice, you can ask for and get the following information each year:

Information about network Providers – at a minimum primary care doctors, specialists, and hospitals in our service area. This information will include names, addresses, telephone numbers, and languages spoken (other than English) for each network provider, plus identification of Providers that are not accepting new patients.
Any limits on your freedom of choice among network Providers
Your rights and responsibilities
Information on complaint, appeal, and fair hearing procedures
Information about benefits available under the Medicaid program, including amount, duration, and scope of benefits. This is designed to make sure you understand the benefits to which you are entitled
How you get benefits, including authorization requirements
How you get benefits, including family planning services, from out-of-network Providers and limits to those benefits.
How you get after hours and emergency coverage and limits to those kinds of benefits, including:
- What makes up emergency medical conditions, emergency services, and post-stabilization services
- The fact that you do not need prior authorization from your Primary Care Provider for emergency care services
- How to get emergency services, including instructions on how to use the 9-1-1 telephone system or its local equivalent
- The addresses of any places where Providers and hospitals furnish emergency services covered by Medicaid
- A statement saying you have a right to use any hospital or other settings for emergency care
- Post-stabilization rules
Policy on referrals for specialty care and for other benefits you cannot get through your Primary Care Provider
Community Health Choice’s practice guidelines

Community Health Choice believes you have the right and responsibility to:

Rights

A right to receive information about the organization, its services, its practitioners and providers and member rights and responsibilities
A right to be treated with respect and recognition of your dignity and your right to privacy
A right to participate with practitioners in making decisions about your health care
A right to a candid discussion of appropriate or medically necessary treatment options for their conditions, regardless of cost or benefit coverage
A right to voice complaints or appeals about the organization or the care it provides
A right to make recommendations regarding the organization’s Member rights and responsibilities policy

Responsibilities

A responsibility to supply information (to the extent possible) that the organization and its practitioners and providers need in order to provide care
A responsibility to follow plans and instructions for care that you have agreed to with their practitioners
A responsibility to understand your health problems and participate in developing mutually agreed-upon treatment goals, to the degree possible

You have a right to tell us what you think of the rights and responsibilities offered to you. Tell us what you think at 1.888.760.2600.

New Technology Assessment

We provide for care that is shown to be safe and useful. We review new health care treatments. We review new procedures. The review uses up to date health data. This is called New Technology Assessment. We decide whether to pay for these things. This review means we pay when safety and value is clear. You may ask us to review new technology. The Texas Vendor Drug Program reviews medications.

Utilization Management Decisions

Community follows guidelines to determine what health care services we cover. This is called utilization management. We know how important it is that we make the right decisions for your care. Community follows three principles when we make these decisions:

Our decisions are based only on whether or not:
- The care and services are appropriate
- It is a covered benefit
We do not reward doctors or anyone else for denying coverage.
We do not give incentives to doctors or anyone else to encourage them to make decisions that would mean you would get less care than you need.
If Community denies your request for services, you can get an independent external review. An independent review is when someone not employed by Community reviews your request for services. This is called a Fair Hearing.

Quality Improvement

Our Quality Improvement Department helps Community give you the best clinical care and service possible. If you want more information about our Quality Improvement Program, please contact Member Services toll-free at 1.888.760.2600.

STD Information

If you need information about sexually-transmitted diseases (STDs) or Human Immunodeficiency Virus (HIV), please call Community’s Member Services at 713.295.2294 or toll-free at 1.888.760.2600.

Moral or Religious Objections

Community Health Choice does not exclude access to any services because of moral or religious objections.

Texas STAR (Medicaid) Plan

Value-Added Services

Service Area Map

Prescription Drug Services

Understanding Insurance

How do I find a Primary Care Provider or clinic?

What is a referral?

HealthCare Definitions

Advance Directives & Second Opinions

How to Apply

Application Assistance

Member Resources

Member Handbook

The Sun Online Newsletter

Community Spotlight Blog

HHSC Notifications

Access2Care Transportation

Care Management Program

Health Risk Assessment

Doctor Decision Guide

Prior Authorization Guide

Prior Authorization Information

Special WIC Food Updates

Member Rights & Forms

Rights and Responsibilities

Privacy Notice

Complaint/Appeal Resolution Process

State Fair Hearing Process

External Medical Review

Complaint Form

How to Submit a Complaint

Annual Notices

Fraud, Waste, and Abuse

Freedom of Choice Services

Subrogation

General Information

How to Replace a Lost/Stolen Member ID Card

Texas Health Steps

Member Advisory Group

Find a Doctor or Get a Referral

Notice of Privacy Practice (NOPP)

Availability of Material in Alternate Formats

24-Hour Medical Help

Hotline Numbers for Providers and Members

Translation Services Taglines/Information and Notice of Non-Discrimination

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

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.

Provider Services Hotline
Call 713.295.2295, 8:00 a.m. - 5:00 p.m., Monday – Friday

Additional Contact Numbers

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

Annual Notices

Annual Notices

Annual Notices

Apply for Texas STAR (Medicaid)

Important Things to Remember

As a Member of Community Health Choice, you can ask for and get the following information each year:​

Community Health Choice believes you have the right and responsibility to:

New Technology Assessment

Why Choose Community?

As a Member of Community Health Choice, you can ask for and get the following information each year: