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Member Testimonials

Diabetes patient finds affordable care with Community

Up until last year, Sophia had been uninsured and long struggling to manage her diabetes. After initially considering going uninsured rather than pay over $650 to be covered under her husband Bennie’s plan from work, she decided to sign up for a Community Health Choice plan. Sophia renewed her plan this year, and her and her husband sat down with us to talk about her time with Community Health Choice.

Why did you pick Community?

Sophia renewed her plan this year, and her and her husband sat down with us to talk about her time with Community Health Choice.

Why did you pick Community?

Bennie: “Mainly it was the premium, as well as the copay, because you don’t know how many times you’re going to have to visit a doctor or specialist, or how many appointments you’re going to need to make.”

Sophia: “Especially with my diabetes. When I was going to the clinic, I was having to go every two or three months to give them my results – when I would check my sugar and what my levels would be and all that – to see if they needed to adjust it, what they can do. So it was like I was just constantly going to the clinic.”

"What I like is when you call customer service,they’re not rushing you"

Are you also making preventative care appointments?

 Sophia: “I’ll be going, because my family has a whole line of cancers and stuff. And it’s always good to get the one year check-up, because you never know what’s going to happen. Or what’s building up to happen you. So you need it.”

What did you do before insurance?

Sophia: “Before we had insurance, I would just go to a doctor and pay the regular fee. And then see if they could just give me a prescription for however long they could and just kind of stretch it out. But even just on that, it’s kind of scary. My sugar levels were really high, so going to sleep, you’re kind of scared not knowing if you’re going to go into a little sugar coma or what. So it’s more a relief now.”

Did you skip doses?

Sophia: “Oh yeah, all the time. And use over the counter insulin. It was pretty crazy.”

What have you liked about having Community Health Choice?

Bennie: “Just knowing she gets everything. Because in the past, she’s had to be admitted to the ER for mismanaging and not being able to keep up with a primary care physician or anything like that. So it’s been good to go ahead and have someone to monitor it and keep on top of it and make sure everything does go good. Because with the kids it’s like we have to watch ourselves, we have to take care of ourselves.”

Did you shop around for health plans this year?

Bennie: “Actually the plan she was on already was pretty much the best one. Like I said, the premium went down and the copays went down, but it was pretty much the same coverage. Sophia: “We looked at the one from my job also, and it wasn’t…this one was better still. You figure going through your company will be a little [better]….but this one was still better.”

What would you tell someone considering buying a marketplace plan?

Bennie: “To first of all shop. Just shop and look at the benefits of all the plans if you want to be smart about it. You want to shop everyone. It just so happened Community Health Choice did offer the best benefits for what we were looking for, and that’s why we went with them. “But there’s too many uncertainties – you don’t want to go uninsured. Because we did debate that. When they were going to pass the health care law, we said, ‘if we don’t get insurance, how is that going to affect us?’” We were looking at that more than what kind of health care we could get. But after I just said, ‘okay we need to look at all of this,’ and finally did, I saw that, yeah it’s doable and the help is there. And it’s a lot better that we have it than trying to think of if we didn’t get it at all. “Well basically after we’ve gotten to know Community Health Choice by having the plan and talking to people we know, they are local and the customer support is way better. As far as when you need answers, you need help, guidance, anything like that, you give them a call and they’ll point you in the right direction. And they’ll let you know how you’re covered and where you can go and how to get to it – how to get to the best care.”

What are your next steps with Community?

Bennie: “It’s been real busy since the end of the year. We’re catching up, and then we’ll be able to really dive into making the appointments, doing the managed care – things like that. We’re really looking forward to another year with Community Health Choice and taking advantage of the benefits. “We’re about to start looking for another provider through the insurance now. It’s been a lot better, since the premium did drop significantly from last year, which is really great, as well as the copay dropped, I’ve seen. And other than that we’re just doing a lot better.” Have you had any trouble finding providers in network? Bennie: “Since we’re gonna go to Kelsey, I’ve seen the locations and they’re pretty convenient to us. We have one that’s really close to where we’re at, so it should be easy for her to get to her appointments, in and out. Other than that, when I’ve had to search for providers, either for diabetes or just for other purposes, it had a pretty extensive list of providers that were in the area or even if we happened to have been somewhere else, I’d say a good number of providers are available.” What is the one thing you would want people to take away from hearing about your experience? Bennie: “I would basically reiterate what I said about them being local, them being affordable, them being helpful – being able to give them the tools you need to be able to make an informed decision about either choosing them, or choosing a provider to help you out with whatever your condition may be, if you just want to do preventative care as well.”

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Community participates in the Children's Health Insurance Program (CHIP), including CHIP Perinatal (CHIP-P). CHIP is a health insurance plan for children under the age of 19 and is designed for families who earn too much money to qualify for Texas Medicaid programs, yet cannot afford to buy private insurance. CHIP-P provides prenatal care for the unborn children of low-income women who do not qualify for Medicaid. More 

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Community proudly offers individual health insurance in the new Health Insurance Marketplace. With a range of plan options to fit any budget, and a network of doctors you can trust, like Kelsey-Seybold Clinic and Memorial Hermann, Community makes it easy to get the care you need and deserve.

During the Health Insurance Marketplace’s open enrollment, October 31 through March 31, our Member Services Department will be extending their hours. We’ll be answering phone calls from 7:00 a.m. – 7:00 p.m. to make sure that you can get the help you need, when you need it.

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Availability of Material in Alternate Formats

Information is available in English and Spanish. Call us to get an interpreter. Information can also be made available in audio, large print, Braille or other languages, if needed.

Call our Member Services toll-free at 1.888.760.2600 to ask for these special services or to answer any questions you may have about the Member Handbook. Call 8:00 a.m. – 6:00 p.m., Monday – Friday, excluding state-approved holidays. Access your Member account online 24 hours a day, seven days a week.

24-Hour Nurse Help Line

  • 1.888.332.2730
  • TDD: 7-1-1
  • 24 hours a day, 7 days a week

  • Call the Nurse Help line before going to the emergency room, unless it is an emergency. A nurse will answer your health care questions and help the Member get the care they need.

    Information is available in English and Spanish. Call us to get an interpreter. In case of an emergency, call 9-1-1 or go to the nearest hospital.

    Member Services Hotline Number

    For information on how to access all of your covered services, including pharmacy and dental information, visit www.CommunityHealthChoice.org. Or call our Member Services toll-free at 1.888.760.2600. Call 8:00 a.m. – 6:00 p.m., Monday – Friday, excluding state-approved holidays. In case of an emergency, call 9-1-1 or go to the nearest hospital. We speak English, Spanish or can get you an interpreter who speaks your language.  TDD: 7-1-1.

    Prescription, Vision, and Dental Benefits Information

    • Prescription Benefits: Community Health Choice Member Services - Toll-free at 1.888.760.2600
    • Vision Benefits: Superior Vision - Toll-free at 1.800.879.6901; www.SuperiorVision.com
    • Value-Added Dental Services for Community Members over 21 years of age: STARDent - Toll-free at 1.866.844.4251
    • Dental Services for all CHIP Members and STAR Members under 21 years of age:
      • MCNA Dental - Toll-free at 1.800.494.6262 - http://www.mcnatx.net/welcome

    Provider Services Hotline Number

    Providers call this number for information on our health plan and our Members that they serve.

    713.295.2295; Monday - Friday; 8:00 a.m. - 5:00 p.m.

    State Fair Hearing Information

    When can I request a State Fair Hearing?

    You can request a State Fair Hearing anytime during or after Community Health Choice’s appeals process. You do not have to follow the internal complaint and appeal’s process before requesting a Fair Hearing.

    Can I ask for a State Fair Hearing?

    If you, as a Member of the health plan, disagree with the health plan’s decision, you have the right to ask for a fair hearing. You may name someone to represent you by writing a letter to the health plan telling them the name of the person you want to represent you. A doctor or other medical Provider may be your representative. If you want to challenge a decision made by your health plan, you or your representative must ask for the fair hearing within 90 days of the date on the health plan’s letter with the decision. If you do not ask for the fair hearing within 90 days, you may lose your right to a fair hearing. To ask for a fair hearing, you or your representative should either send a letter to the health plan at:

    Community Health Choice, Inc.
    Member Appeals Coordinator
    2636 South Loop West, Suite 125
    Houston, TX 77054

  • Or call toll-free at 1.888.760.2600.
  • You have the right to keep getting any service the health plan denied or reduced, at least until the final hearing decision is made if you ask for a fair hearing by the later of: (1) 10 calendar days following the MCO’s mailing of the notice of the Action, or (2) the day the health plan’s letter says your service will be reduced or end. If you do not request a fair hearing by this date, the service the health plan denied will be stopped.

    If you ask for a fair hearing, you will get a packet of information letting you know the date, time, and location of the hearing. Most fair hearings are held by telephone. At that time, you or your representative can tell why you need the service the health plan denied. HHSC will give you a final decision within 90 days from the date you asked for the hearing.

    Behavioral Health/Substance Abuse Services Crisis Hotline

    Beacon Health Options
    1-877-343-3108
    24 hours a day, 7 days a week

    Information is available in English and Spanish. Call us to get an interpreter. In case of an emergency, call 9-1-1 or go to the nearest hospital. This includes assessment, counseling, and treatment services. Services provided by a licensed psychologist, licensed professional counselor, licensed master’s social worker, advanced clinical practitioner or licensed marriage and family therapist are not covered for Members 21 years and older. You do not need a referral for behavioral (mental) health services or drug and alcohol treatment. Community Health Choice follows the Mental Health Parity Addiction Equity Act (MHPAEA). We review to make sure that requirements for mental health benefits are the same or less than medical benefits.

    Translation Services Taglines/Information and Notice of Non-Discrimination

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    MARKETPLACE MEMBERS: Make online payments

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    CHIP Member Handbook

    Community participates in the Children's Health Insurance Program (CHIP), including CHIP Perinatal (CHIP-P). CHIP is a health insurance plan for children under the age of 19 and is designed for families who earn too much money to qualify for Texas Medicaid programs, yet cannot afford to buy private insurance. CHIP-P provides prenatal care for the unborn children of low-income women who do not qualify for Medicaid. More 

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    Texas STAR Plan

    STAR Member Handbook

    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 at no cost to U.S. residents who cannot afford health insurance. More

    Five young adults friends with arms around each other smiling.

    Marketplace Plans

    Marketplace Handbook

    Community proudly offers individual health insurance in the new Health Insurance Marketplace. With a range of plan options to fit any budget, and a network of doctors you can trust, like Kelsey-Seybold Clinic and Memorial Hermann, Community makes it easy to get the care you need and deserve.

    During the Health Insurance Marketplace’s open enrollment, October 31 through March 31, our Member Services Department will be extending their hours. We’ll be answering phone calls from 7:00 a.m. – 7:00 p.m. to make sure that you can get the help you need, when you need it.

    More  
    Outdoor portrait of a cute young black sisters smiling

    Formulary and Drug Cost Information

    Formulary and Drug Cost Information

    Availability of Material in Alternate Formats

    Information is available in English and Spanish. Call us to get an interpreter. Information can also be made available in audio, large print, Braille or other languages, if needed.

    Call our Member Services toll-free at 1.888.760.2600 to ask for these special services or to answer any questions you may have about the Member Handbook. Call 8:00 a.m. – 6:00 p.m., Monday – Friday, excluding state-approved holidays. Access your Member account online 24 hours a day, seven days a week.

    24-Hour Nurse Help Line

  • 1.888.332.2730
  • TDD: 7-1-1
  • 24 hours a day, 7 days a week

  • Call the Nurse Help line before going to the emergency room, unless it is an emergency. A nurse will answer your health care questions and help the Member get the care they need.

    Information is available in English and Spanish. Call us to get an interpreter. In case of an emergency, call 9-1-1 or go to the nearest hospital.

    Member Services Hotline Number

    For information on how to access all of your covered services, including pharmacy and dental information, visit www.CommunityHealthChoice.org. Or call our Member Services toll-free at 1.888.760.2600. Call 8:00 a.m. – 6:00 p.m., Monday – Friday, excluding state-approved holidays. In case of an emergency, call 9-1-1 or go to the nearest hospital. We speak English, Spanish or can get you an interpreter who speaks your language.  TDD: 7-1-1.

    Prescription, Vision, and Dental Benefits Information

    • Prescription Benefits: Community Health Choice Member Services - Toll-free at 1.888.760.2600
    • Vision Benefits: Superior Vision - Toll-free at 1.800.879.6901; www.SuperiorVision.com
    • Value-Added Dental Services for Community Members over 21 years of age: STARDent - Toll-free at 1.866.844.4251
    • Dental Services for all CHIP Members and STAR Members under 21 years of age:
      • MCNA Dental - Toll-free at 1.800.494.6262 - http://www.mcnatx.net/welcome

    Provider Services Hotline Number

    Providers call this number for information on our health plan and our Members that they serve.

    713.295.2295; Monday - Friday; 8:00 a.m. - 5:00 p.m.

    State Fair Hearing Information

    When can I request a State Fair Hearing?

    You can request a State Fair Hearing anytime during or after Community Health Choice’s appeals process. You do not have to follow the internal complaint and appeal’s process before requesting a Fair Hearing.

    Can I ask for a State Fair Hearing?

    If you, as a Member of the health plan, disagree with the health plan’s decision, you have the right to ask for a fair hearing. You may name someone to represent you by writing a letter to the health plan telling them the name of the person you want to represent you. A doctor or other medical Provider may be your representative. If you want to challenge a decision made by your health plan, you or your representative must ask for the fair hearing within 90 days of the date on the health plan’s letter with the decision. If you do not ask for the fair hearing within 90 days, you may lose your right to a fair hearing. To ask for a fair hearing, you or your representative should either send a letter to the health plan at:

    Community Health Choice, Inc.
    Member Appeals Coordinator
    2636 South Loop West, Suite 125
    Houston, TX 77054

  • Or call toll-free at 1.888.760.2600.
  • You have the right to keep getting any service the health plan denied or reduced, at least until the final hearing decision is made if you ask for a fair hearing by the later of: (1) 10 calendar days following the MCO’s mailing of the notice of the Action, or (2) the day the health plan’s letter says your service will be reduced or end. If you do not request a fair hearing by this date, the service the health plan denied will be stopped.

    If you ask for a fair hearing, you will get a packet of information letting you know the date, time, and location of the hearing. Most fair hearings are held by telephone. At that time, you or your representative can tell why you need the service the health plan denied. HHSC will give you a final decision within 90 days from the date you asked for the hearing.

    Behavioral Health/Substance Abuse Services Crisis Hotline

    Beacon Health Options
    1-877-343-3108
    24 hours a day, 7 days a week

    Information is available in English and Spanish. Call us to get an interpreter. In case of an emergency, call 9-1-1 or go to the nearest hospital. This includes assessment, counseling, and treatment services. Services provided by a licensed psychologist, licensed professional counselor, licensed master’s social worker, advanced clinical practitioner or licensed marriage and family therapist are not covered for Members 21 years and older. You do not need a referral for behavioral (mental) health services or drug and alcohol treatment. Community Health Choice follows the Mental Health Parity Addiction Equity Act (MHPAEA). We review to make sure that requirements for mental health benefits are the same or less than medical benefits.

    Translation Services Taglines/Information and Notice of Non-Discrimination

    Language Services Addendum/Taglines and Non-Discrimination Notice

    HHSC Notifications

    HHSC Notifications

    MARKETPLACE MEMBERS: Make online payments

    Three young girls smiling with arms around each other

    Texas CHIP Plan

    CHIP Member Handbook

    Community participates in the Children's Health Insurance Program (CHIP), including CHIP Perinatal (CHIP-P). CHIP is a health insurance plan for children under the age of 19 and is designed for families who earn too much money to qualify for Texas Medicaid programs, yet cannot afford to buy private insurance. CHIP-P provides prenatal care for the unborn children of low-income women who do not qualify for Medicaid. More 

    Mother holding newborn baby

    Texas STAR Plan

    STAR Member Handbook

    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 at no cost to U.S. residents who cannot afford health insurance. More

    Five young adults friends with arms around each other smiling.

    Marketplace Plans

    Marketplace Handbook

    Community proudly offers individual health insurance in the new Health Insurance Marketplace. With a range of plan options to fit any budget, and a network of doctors you can trust, like Kelsey-Seybold Clinic and Memorial Hermann, Community makes it easy to get the care you need and deserve.

    During the Health Insurance Marketplace’s open enrollment, October 31 through March 31, our Member Services Department will be extending their hours. We’ll be answering phone calls from 7:00 a.m. – 7:00 p.m. to make sure that you can get the help you need, when you need it.

    More  
    Outdoor portrait of a cute young black sisters smiling

    Formulary and Drug Cost Information

    Formulary and Drug Cost Information

    Availability of Material in Alternate Formats

    Information is available in English and Spanish. Call us to get an interpreter. Information can also be made available in audio, large print, Braille or other languages, if needed.

    Call our Member Services toll-free at 1.888.760.2600 to ask for these special services or to answer any questions you may have about the Member Handbook. Call 8:00 a.m. – 6:00 p.m., Monday – Friday, excluding state-approved holidays. Access your Member account online 24 hours a day, seven days a week.

    24-Hour Nurse Help Line

  • 1.888.332.2730
  • TDD: 7-1-1
  • 24 hours a day, 7 days a week

  • Call the Nurse Help line before going to the emergency room, unless it is an emergency. A nurse will answer your health care questions and help the Member get the care they need.

    Information is available in English and Spanish. Call us to get an interpreter. In case of an emergency, call 9-1-1 or go to the nearest hospital.

    Member Services Hotline Number

    For information on how to access all of your covered services, including pharmacy and dental information, visit www.CommunityHealthChoice.org. Or call our Member Services toll-free at 1.888.760.2600. Call 8:00 a.m. – 6:00 p.m., Monday – Friday, excluding state-approved holidays. In case of an emergency, call 9-1-1 or go to the nearest hospital. We speak English, Spanish or can get you an interpreter who speaks your language.  TDD: 7-1-1.

    Prescription, Vision, and Dental Benefits Information

    • Prescription Benefits: Community Health Choice Member Services - Toll-free at 1.888.760.2600
    • Vision Benefits: Superior Vision - Toll-free at 1.800.879.6901; www.SuperiorVision.com
    • Value-Added Dental Services for Community Members over 21 years of age: STARDent - Toll-free at 1.866.844.4251
    • Dental Services for all CHIP Members and STAR Members under 21 years of age:
      • MCNA Dental - Toll-free at 1.800.494.6262 - http://www.mcnatx.net/welcome

    Provider Services Hotline Number

    Providers call this number for information on our health plan and our Members that they serve.

    713.295.2295; Monday - Friday; 8:00 a.m. - 5:00 p.m.

    State Fair Hearing Information

    When can I request a State Fair Hearing?

    You can request a State Fair Hearing anytime during or after Community Health Choice’s appeals process. You do not have to follow the internal complaint and appeal’s process before requesting a Fair Hearing.

    Can I ask for a State Fair Hearing?

    If you, as a Member of the health plan, disagree with the health plan’s decision, you have the right to ask for a fair hearing. You may name someone to represent you by writing a letter to the health plan telling them the name of the person you want to represent you. A doctor or other medical Provider may be your representative. If you want to challenge a decision made by your health plan, you or your representative must ask for the fair hearing within 90 days of the date on the health plan’s letter with the decision. If you do not ask for the fair hearing within 90 days, you may lose your right to a fair hearing. To ask for a fair hearing, you or your representative should either send a letter to the health plan at:

    Community Health Choice, Inc.
    Member Appeals Coordinator
    2636 South Loop West, Suite 125
    Houston, TX 77054

  • Or call toll-free at 1.888.760.2600.
  • You have the right to keep getting any service the health plan denied or reduced, at least until the final hearing decision is made if you ask for a fair hearing by the later of: (1) 10 calendar days following the MCO’s mailing of the notice of the Action, or (2) the day the health plan’s letter says your service will be reduced or end. If you do not request a fair hearing by this date, the service the health plan denied will be stopped.

    If you ask for a fair hearing, you will get a packet of information letting you know the date, time, and location of the hearing. Most fair hearings are held by telephone. At that time, you or your representative can tell why you need the service the health plan denied. HHSC will give you a final decision within 90 days from the date you asked for the hearing.

    Behavioral Health/Substance Abuse Services Crisis Hotline

    Beacon Health Options
    1-877-343-3108
    24 hours a day, 7 days a week

    Information is available in English and Spanish. Call us to get an interpreter. In case of an emergency, call 9-1-1 or go to the nearest hospital. This includes assessment, counseling, and treatment services. Services provided by a licensed psychologist, licensed professional counselor, licensed master’s social worker, advanced clinical practitioner or licensed marriage and family therapist are not covered for Members 21 years and older. You do not need a referral for behavioral (mental) health services or drug and alcohol treatment. Community Health Choice follows the Mental Health Parity Addiction Equity Act (MHPAEA). We review to make sure that requirements for mental health benefits are the same or less than medical benefits.

    Translation Services Taglines/Information and Notice of Non-Discrimination

    Language Services Addendum/Taglines and Non-Discrimination Notice

    HHSC Notifications

    HHSC Notifications