you have chosen CommunityFirst Health Plans, your next step is
to select who will provide the majority of health care services
to you and your eligible dependents. Your primary care physician (PCP)
will be the one you call when you need medical advice, when you are sick, and
when you need preventive care such as immunizations.
Each participant may select his or her own PCP from the Community First Provider Directory.
Select a PCP who is a family or general practitioner, internist, or pediatrician. Contact Community First Member Services at (210) 358-6262 or toll-free (877) 698-7032 to let us know of the PCP choice for yourself and your dependents.
If you have a chronic, disabling, or life-threatening condition, you may request to
use a specialty care provider (SCP) as your PCP.
Just call Member Services at (210) 358-6262 or toll-free (877) 698-7032 to make your request. Your request
must include information about the medical necessity of your request and be signed by you
and your SCP.
For your SCP to
be named as your
PCP, he or she
must meet all
of Community First's
PCPs and be willing
to accept the
all of your health
Community First covers a full range of specialty services. If you require treatment by a medical specialist, check with your PCP to determine if a referral is required to see a particular specialist. Although Community First does not require a referral to see a specialist, some specialists require a referral from your PCP in order to see you. NOTE: You are not required to obtain a referral from your PCP to access care from an OB/GYN or behavioral health provider within the Community First network. Some facility-based physicians or other health care practitioners, such as anesthesiologists, pathologists, and radiologists, may not be included in Community First's network and may balance bill you for amounts not paid by Community First. If you receive a bill, call Member Services at (210) 358-6262 or toll-free (877) 698-7032. Be sure to have a copy of the bill in front of you when you call.
Community First Health Plans will provide services
in the following Texas counties: Atascosa, Bandera,
Bexar, Comal, Guadalupe, Kendall, Medina, and
Wilson. The Service Area Map provides an illustration of the counties included in the Community First service area.
If you wish
to change your
PCP, please call
the Member Services
the phone numbers
will be happy
to assist you.