Community First Health Plans 12238 Silicon Drive, San Antonio, TX 78249

"I have been referred to see an ENT doctor but there is an over-month waiting list because the ENT doctor I need to see practices only two days a month in Community First Health Network. so I referred them last November my appointment was set up for March 2024 I requested from the community first to see an ENT outside the network, but they refused. By the way, I called some ENT offices in San Antonio, and I was told by two different ENTs they do not accept community-first medical insurance. I asked the community's first health manager to find an ENT for me, but as of today (01/24/2024) they have not found any who accept my insurance. I believe the community first health plan is the worst medical insurance in San Antonio."

"We work there place all people employees great friend smile to us we do clean janitor restroom and cafe and office too smile keep fresh clean business clean"

"I am extremely frustrated with Community First. I have been trying to see a specialist for a preexisting condition that is out of network, and I have gotten conflicting information over and over again. I was instructed by a Community First staff person to have my PCP submit authorization for an out of network provider, and I did so. I waited 2 months to hear back. Only for it to be “voided” by the authorizations department because they didn’t read fine print and said that provider is covered by my plan. And the provider is not covered!! To which they never notified my PCP office of the void. Now I’m being asked to redo the entire process with my PCP submitting authorization because they cannot undo the voided auth. Along with a personal phone call from my PCP office to Community First to ensure it goes through. Sure. As if my PCP has time for all of this. This has significantly delayed my care and health maintenance. I would hope an insurer could be able to tell you who is covered and who is not on your insurance plan. And that their staff would read the fine print of an authorization. Not here. Extremely dissatisfied and disappointed."

"Worst medicaid ever. Member services are no help at all. I have different PCPs on file that I NEVER even seen before. Ive been hung up on & there are zero benefits provided to me on my plan. I am a pregnant woman on this medicaid plan with no help at all! Please choose a different plan for you & your baby! I am already in process of switching plans. I wish I would have read the reviews before choosing."

"We are experiencing a difficult claims issue. My husband met his coinsurance maximum of $2000 in June of 2021. He had a subsequent ER visit that was processed with coinsurance assigned. We spoke with Christina, a member advocate yesterday. She said it had been resolved and she did not need to discuss it with us further. When we asked to speak with a supervisor, she hung up the phone. This claim has yet to be processed correctly. I need answers to the following questions: 1.) When was his coinsurance maximum reached? 2.) Why was coinsurance applied to this visit in July after the coinsurance maximum was reached? ******UPDATE***** Yesterday, I spoke with Hopi, a supervisor with CFHP. She indicated first that the service was a readmission. However, this is for an emergency room visit that took place three weeks after the procedure. Then, she said that our 20% was not a coinsurance and did not count towards the coinsurance maximum rules. When I asked for information from the SPD that indicates these are the terms of our plan, Hopi said that we need to contact HR because they don't have anything to do with the State of Texas employees anymore. She said the issue is closed and that she will not provide additional informaion."