What is Medicaid?

Community Health Choice (Community) participates in the State of Texas Access Reform (STAR) Managed Care Program (Medicaid). As a part of Medicaid, Community provides both Children’s Medicaid and Medicaid for Pregnant Women. These programs are free to U.S. residents who cannot afford health insurance.

How does Medicaid work?

Under the Medicaid Program, eligible Medicaid clients choose an HMO and a Primary Care Provider (PCP) to provide all primary care services and to arrange for and coordinate referrals for all medically necessary specialty services.

For Children’s Medicaid, income levels that determine eligibility vary based on age and Medicaid program. Eligible participants for Medicaid for Pregnant Women must be at 185 percent of the Federal Poverty Level (FPL) or lower. Children’s Medicaid covers a child up to his or her 21st birthday, and Medicaid for Pregnant Women covers a child-bearing woman of any age. Members must recertify every six months.

What services does Medicaid cover?

Community provides its Medicaid Members with access to comprehensive medical care, including services such as hospital care, surgery, X-rays, physical/speech/occupational therapies, prescription drugs, emergency services, transplants, regular health checkups, and immunizations.

  • Adults get one physical exam per year not covered in regular Medicaid
  • Dental services for Members age 21 and over
  • Vision benefits, including contact lenses
  • Free events at various venues within the service area
  • Children's Wellness Gift Program up to age 21
  • 24-hour Nurse Help line
  • Transportation assistance
  • Care Management Programs for asthma and diabetes
  • School sports physicals
  • Help with Medicaid recertification
  • High-risk Pregnancy Program