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CHIP is a managed care plan for uninsured children in Texas. Our objective is to ensure that CHIP Members access primary care services appropriately and receive services in the most cost-effective setting. Our network comprises physicians, allied and ancillary health care providers, hospitals and other facilities selected to provide quality health care to our CHIP Members. The Primary Care Physician (PCP) is responsible for managing the overall medical care of patients, and coordinating referrals to specialists and inpatient/outpatient facilities. The PCP is a Community First network provider with one of the following specialties: General Practice, Family Practice, Pediatrics or Internal Medicine, Obstetrics and Gynecology (pregnant women only), Pediatrics, Federally Qualified Health Centers (FQHCs) or Rural Health Clinics (RHCs). In addition, Community First Health Plans STAR members can access contracted Advance Practice Nurses, Physician Assistants, and Certified Nurse Midwives practicing under the supervision of a physician for appropriate covered services.
Community First's STAR/Medicaid service area includes the following counties: Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina, Wilson.
The Children's Health Insurance Program (CHIP Perinatal) Perinatal Program provides services to unborn children of non-Medicaid eligible women. Unborn children will be eligible from conception and, once enrolled, they will receive 12 months of continuous eligibility.
The Texas Managed Medicaid STAR/CHIP formulary, including the Preferred Drug List and any clinical edits, is defined by the Texas Vendor Drug Program.
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