Am I Eligible?

Who can qualify for a Dual-Eligible Special Needs Plan (D-SNP)?

You can enroll in this plan if you qualify for STAR or STAR+PLUS (Medicaid), based on Federal requirements and standards established by the State of Texas. STAR or STAR+PLUS will provide assistance with Medicare cost-sharing. Your STAR or STAR+PLUS plan also provides full Medicaid benefits. Your cost-share is $0 when the service is covered by both Medicare and Texas Medicaid.

You are eligible to join the Community Health Choice (HMO D-SNP) plan if you answer “yes” to the following questions:
  • Do you have Medicare Parts A and B?

  • Are you at least 65 years old, or age 21 or older and qualify based on disability or another special situation?

  • Do you qualify for STAR or STAR+PLUS (Medicaid)?

  • 21 years of age or older and qualify based on disability or another special situation
  • 65 years of age or older and receive Extra Help or assistance from the State
  • Eligible for Texas Medicaid (QMB, QMB+, and SLMB+)
  • 20 counties in Southeast Texas (see map)
  • Only individuals living in our plan’s service area are eligible to enroll in Community Health Choice’s (HMO D-SNP).

If your category of Medicaid eligibility changes, your eligibility for this plan will change. You will have a 6-month grace period to achieve Medicaid re-determination and will continue to be covered under this plan. During this grace period, you will be responsible for the costs of your Medicare benefits, which will be the same as if you were on Original Medicare.

Medicaid vs Medicare: You Can Have Both

To enroll in a D-SNP, you must be eligible for both STAR or STAR+PLUS (Medicaid) and Medicare.

You qualify for STAR or STAR+PLUS (Medicaid) if you meet the low-income requirements established by the State of Texas.

You qualify for Medicare based on age (being 65 or older) or disability.

People who qualify for both Medicaid and Medicare are called “dual-eligible.” That also makes them eligible for a dual eligible special needs plan (D-SNP).

If you enroll in the Community Health Choice HMO D-SNP, you keep the same STAR or STAR+PLUS plan and all the same Medicaid benefits you get now. Enrolling in Community’s HMO-DSNP won’t change your STAR or STAR+PLUS plan benefits in any way. Plus, you could get more Medicare benefits!

Not sure if you qualify?

One of our representatives can help! Call us at 833.276.8306 (toll-free) or 713.295.5007 (local). TTY users should call 711.

Resources

Still have questions?

Speak to a Community Health Choice Medicare plan specialist by calling:

October 1 to March 31, 8:00 am to 8:00 pm, 7 days a week, and April 1 through September 30, 8:00 am to 8:00 pm, Monday through Friday. On certain holidays your call will be handled by our automated phone system.

Footnotes

Community Health Choice Texas, Inc. is a (HMO D-SNP) plan with a Medicare contract. Enrollment in our plans depends on contract renewal.
ATTENTION: If you speak Spanish, language assistance services, free of charge, are available to you. Call 1.833.276.8306 (TTY: 711)
Community Health Choice Texas, Inc.’s pharmacy network includes limited lower-cost, preferred pharmacies in our 20-county service area. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1.833.276.8306 (TTY: 711) or consult the online pharmacy directory at communityhealthchoice.org/medicare

H9826_MK_10331_100422_M. Last updated October 4, 2022.

Medicare Open Enrollment

Call to learn more about our Medicare plan

Current Members Call 1.833.276.8306 TTY: 711 
New members Call 1.855.940-3767 TTY: 711